Accuracy of Parkinson's disease diagnosis in 610 general practice patients in the West of Scotland.
Identifieur interne : 001B05 ( PubMed/Curation ); précédent : 001B04; suivant : 001B06Accuracy of Parkinson's disease diagnosis in 610 general practice patients in the West of Scotland.
Auteurs : Edward J. Newman [Royaume-Uni] ; Kieran Breen ; Jim Patterson ; Donald M. Hadley ; Katherine A. Grosset ; Donald G. GrossetSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2009.
English descriptors
- KwdEn :
- Aged, Aged, 80 and over, Case-Control Studies, Essential Tremor (diagnosis), Essential Tremor (radionuclide imaging), Female, Follow-Up Studies, Humans, Male, Parkinson Disease (diagnosis), Parkinson Disease (radionuclide imaging), Physician's Practice Patterns (statistics & numerical data), Radiopharmaceuticals (diagnostic use), Scotland (epidemiology), Tomography, Emission-Computed, Single-Photon (methods), Tropanes (diagnostic use).
- MESH :
- chemical , diagnostic use : Radiopharmaceuticals, Tropanes.
- geographic , epidemiology : Scotland.
- diagnosis : Essential Tremor, Parkinson Disease.
- methods : Tomography, Emission-Computed, Single-Photon.
- radionuclide imaging : Essential Tremor, Parkinson Disease.
- statistics & numerical data : Physician's Practice Patterns.
- Aged, Aged, 80 and over, Case-Control Studies, Female, Follow-Up Studies, Humans, Male.
Abstract
UK-based community studies have found high rates of misdiagnosis in Parkinson's disease (PD). Searches of prescription databases and case records identified 610 patients taking antiparkinson therapy for a PD diagnosis in 92 West of Scotland General Practices. Patients with no documented progression of parkinsonism and/or no increase in antiparkinson medication for 3 years were assessed by two movement disorder specialists. FP-CIT SPECT scanning was performed in clinically uncertain cases. Those considered unlikely to have PD had antiparkinson drugs tapered then stopped, with a minimum of 6 months follow-up. Age, sex and disease duration matched controls were also assessed. 64 of 89 (71.9%) patients meeting selection criteria were assessed, of whom 36 (56.3%) were appropriate for therapy withdrawal. Thirty three of those 36 patients (91.7%) and 3 of 64 (4.7%) controls stopped antiparkinson therapy without deterioration giving an overall total of 36 of 610 (5.9%). The revised diagnoses in this group were mainly essential tremor (ET) (n = 14) and vascular parkinsonism (VP) (n = 10). Patients managed in Primary Care were significantly more likely to complete therapy withdrawal than those attending a specialist clinic (15.3% vs. 2.6%, P < 0.0001). The total annual cost of antiparkinson medication for these 36 patients was 13,400 pounds; the mean duration of diagnosis was 6.8 years (SD 5.6). At least 1 in every 20 patients taking medication for PD is misdiagnosed. Nearly all of these patients can be identified by simple screening of prescription databases and case records in Primary Care, followed by clinical review, which allows withdrawal of unnecessary medication.
DOI: 10.1002/mds.22829
PubMed: 19890985
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Newman</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, Institute of Neurological Sciences, Southern General Hospital, Glasgow, UK. edward.newman@nhs.net</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Neurology, Institute of Neurological Sciences, Southern General Hospital, Glasgow</wicri:regionArea></affiliation></author><author><name sortKey="Breen, Kieran" sort="Breen, Kieran" uniqKey="Breen K" first="Kieran" last="Breen">Kieran Breen</name></author><author><name sortKey="Patterson, Jim" sort="Patterson, Jim" uniqKey="Patterson J" first="Jim" last="Patterson">Jim Patterson</name></author><author><name sortKey="Hadley, Donald M" sort="Hadley, Donald M" uniqKey="Hadley D" first="Donald M" last="Hadley">Donald M. Hadley</name></author><author><name sortKey="Grosset, Katherine A" sort="Grosset, Katherine A" uniqKey="Grosset K" first="Katherine A" last="Grosset">Katherine A. Grosset</name></author><author><name sortKey="Grosset, Donald G" sort="Grosset, Donald G" uniqKey="Grosset D" first="Donald G" last="Grosset">Donald G. Grosset</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2009">2009</date><idno type="doi">10.1002/mds.22829</idno><idno type="RBID">pubmed:19890985</idno><idno type="pmid">19890985</idno><idno type="wicri:Area/PubMed/Corpus">001B05</idno><idno type="wicri:Area/PubMed/Curation">001B05</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Accuracy of Parkinson's disease diagnosis in 610 general practice patients in the West of Scotland.</title><author><name sortKey="Newman, Edward J" sort="Newman, Edward J" uniqKey="Newman E" first="Edward J" last="Newman">Edward J. Newman</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, Institute of Neurological Sciences, Southern General Hospital, Glasgow, UK. edward.newman@nhs.net</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Neurology, Institute of Neurological Sciences, Southern General Hospital, Glasgow</wicri:regionArea></affiliation></author><author><name sortKey="Breen, Kieran" sort="Breen, Kieran" uniqKey="Breen K" first="Kieran" last="Breen">Kieran Breen</name></author><author><name sortKey="Patterson, Jim" sort="Patterson, Jim" uniqKey="Patterson J" first="Jim" last="Patterson">Jim Patterson</name></author><author><name sortKey="Hadley, Donald M" sort="Hadley, Donald M" uniqKey="Hadley D" first="Donald M" last="Hadley">Donald M. Hadley</name></author><author><name sortKey="Grosset, Katherine A" sort="Grosset, Katherine A" uniqKey="Grosset K" first="Katherine A" last="Grosset">Katherine A. Grosset</name></author><author><name sortKey="Grosset, Donald G" sort="Grosset, Donald G" uniqKey="Grosset D" first="Donald G" last="Grosset">Donald G. Grosset</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="eISSN">1531-8257</idno><imprint><date when="2009" type="published">2009</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Case-Control Studies</term><term>Essential Tremor (diagnosis)</term><term>Essential Tremor (radionuclide imaging)</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Male</term><term>Parkinson Disease (diagnosis)</term><term>Parkinson Disease (radionuclide imaging)</term><term>Physician's Practice Patterns (statistics & numerical data)</term><term>Radiopharmaceuticals (diagnostic use)</term><term>Scotland (epidemiology)</term><term>Tomography, Emission-Computed, Single-Photon (methods)</term><term>Tropanes (diagnostic use)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="diagnostic use" xml:lang="en"><term>Radiopharmaceuticals</term><term>Tropanes</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Scotland</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Essential Tremor</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Tomography, Emission-Computed, Single-Photon</term></keywords><keywords scheme="MESH" qualifier="radionuclide imaging" xml:lang="en"><term>Essential Tremor</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Physician's Practice Patterns</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Case-Control Studies</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Male</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">UK-based community studies have found high rates of misdiagnosis in Parkinson's disease (PD). Searches of prescription databases and case records identified 610 patients taking antiparkinson therapy for a PD diagnosis in 92 West of Scotland General Practices. Patients with no documented progression of parkinsonism and/or no increase in antiparkinson medication for 3 years were assessed by two movement disorder specialists. FP-CIT SPECT scanning was performed in clinically uncertain cases. Those considered unlikely to have PD had antiparkinson drugs tapered then stopped, with a minimum of 6 months follow-up. Age, sex and disease duration matched controls were also assessed. 64 of 89 (71.9%) patients meeting selection criteria were assessed, of whom 36 (56.3%) were appropriate for therapy withdrawal. Thirty three of those 36 patients (91.7%) and 3 of 64 (4.7%) controls stopped antiparkinson therapy without deterioration giving an overall total of 36 of 610 (5.9%). The revised diagnoses in this group were mainly essential tremor (ET) (n = 14) and vascular parkinsonism (VP) (n = 10). Patients managed in Primary Care were significantly more likely to complete therapy withdrawal than those attending a specialist clinic (15.3% vs. 2.6%, P < 0.0001). The total annual cost of antiparkinson medication for these 36 patients was 13,400 pounds; the mean duration of diagnosis was 6.8 years (SD 5.6). At least 1 in every 20 patients taking medication for PD is misdiagnosed. Nearly all of these patients can be identified by simple screening of prescription databases and case records in Primary Care, followed by clinical review, which allows withdrawal of unnecessary medication.</div></front></TEI><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">19890985</PMID><DateCreated><Year>2009</Year><Month>12</Month><Day>28</Day></DateCreated><DateCompleted><Year>2010</Year><Month>03</Month><Day>04</Day></DateCompleted><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1531-8257</ISSN><JournalIssue CitedMedium="Internet"><Volume>24</Volume><Issue>16</Issue><PubDate><Year>2009</Year><Month>Dec</Month><Day>15</Day></PubDate></JournalIssue><Title>Movement disorders : official journal of the Movement Disorder Society</Title><ISOAbbreviation>Mov. Disord.</ISOAbbreviation></Journal><ArticleTitle>Accuracy of Parkinson's disease diagnosis in 610 general practice patients in the West of Scotland.</ArticleTitle><Pagination><MedlinePgn>2379-85</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1002/mds.22829</ELocationID><Abstract><AbstractText>UK-based community studies have found high rates of misdiagnosis in Parkinson's disease (PD). Searches of prescription databases and case records identified 610 patients taking antiparkinson therapy for a PD diagnosis in 92 West of Scotland General Practices. Patients with no documented progression of parkinsonism and/or no increase in antiparkinson medication for 3 years were assessed by two movement disorder specialists. FP-CIT SPECT scanning was performed in clinically uncertain cases. Those considered unlikely to have PD had antiparkinson drugs tapered then stopped, with a minimum of 6 months follow-up. Age, sex and disease duration matched controls were also assessed. 64 of 89 (71.9%) patients meeting selection criteria were assessed, of whom 36 (56.3%) were appropriate for therapy withdrawal. Thirty three of those 36 patients (91.7%) and 3 of 64 (4.7%) controls stopped antiparkinson therapy without deterioration giving an overall total of 36 of 610 (5.9%). The revised diagnoses in this group were mainly essential tremor (ET) (n = 14) and vascular parkinsonism (VP) (n = 10). Patients managed in Primary Care were significantly more likely to complete therapy withdrawal than those attending a specialist clinic (15.3% vs. 2.6%, P < 0.0001). The total annual cost of antiparkinson medication for these 36 patients was 13,400 pounds; the mean duration of diagnosis was 6.8 years (SD 5.6). At least 1 in every 20 patients taking medication for PD is misdiagnosed. Nearly all of these patients can be identified by simple screening of prescription databases and case records in Primary Care, followed by clinical review, which allows withdrawal of unnecessary medication.</AbstractText><CopyrightInformation>(c) 2009 Movement Disorder Society.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Newman</LastName><ForeName>Edward J</ForeName><Initials>EJ</Initials><AffiliationInfo><Affiliation>Department of Neurology, Institute of Neurological Sciences, Southern General Hospital, Glasgow, UK. edward.newman@nhs.net</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Breen</LastName><ForeName>Kieran</ForeName><Initials>K</Initials></Author><Author ValidYN="Y"><LastName>Patterson</LastName><ForeName>Jim</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>Hadley</LastName><ForeName>Donald M</ForeName><Initials>DM</Initials></Author><Author ValidYN="Y"><LastName>Grosset</LastName><ForeName>Katherine A</ForeName><Initials>KA</Initials></Author><Author ValidYN="Y"><LastName>Grosset</LastName><ForeName>Donald G</ForeName><Initials>DG</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Mov Disord</MedlineTA><NlmUniqueID>8610688</NlmUniqueID><ISSNLinking>0885-3185</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D019275">Radiopharmaceuticals</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D014326">Tropanes</NameOfSubstance></Chemical><Chemical><RegistryNumber>155797-99-2</RegistryNumber><NameOfSubstance UI="C087552">2-carbomethoxy-8-(3-fluoropropyl)-3-(4-iodophenyl)tropane</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000368">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000369">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D016022">Case-Control Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D020329">Essential Tremor</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000175">diagnosis</QualifierName><QualifierName MajorTopicYN="N" UI="Q000531">radionuclide imaging</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D005260">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D005500">Follow-Up Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D006801">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D008297">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D010300">Parkinson Disease</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000175">diagnosis</QualifierName><QualifierName MajorTopicYN="N" UI="Q000531">radionuclide imaging</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="Y" UI="D010818">Physician's Practice Patterns</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000706">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D019275">Radiopharmaceuticals</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000176">diagnostic use</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" Type="Geographic" UI="D012606">Scotland</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000453">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D015899">Tomography, Emission-Computed, Single-Photon</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000379">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D014326">Tropanes</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000176">diagnostic use</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2009</Year><Month>11</Month><Day>6</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2009</Year><Month>11</Month><Day>6</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2010</Year><Month>3</Month><Day>5</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="doi">10.1002/mds.22829</ArticleId><ArticleId IdType="pubmed">19890985</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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