The use of a color coded probability scale to interpret smell tests in suspected parkinsonism
Identifieur interne : 001757 ( Main/Corpus ); précédent : 001756; suivant : 001758The use of a color coded probability scale to interpret smell tests in suspected parkinsonism
Auteurs : Laura Silveira-Moriyama ; Aviva Petrie ; David R. Williams ; Andrew Evans ; Regina Katzenschlager ; Egberto R. Barbosa ; Andrew J. LeesSource :
- Movement Disorders [ 0885-3185 ] ; 2009-06-15.
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Abstract
Smell identification tests (SITs) have been suggested as useful in the differential diagnosis of Parkinson's disease (PD). We have applied the 40 item University of Pennsylvania SIT (UPSIT‐40) and/or the 16 item SIT from Sniffin Sticks (SS‐16) to 193 nondemented PD patients and 157 controls and used logistic regression analysis to associate the SIT result with the probability of an individual patient having PD (“PD probability”). Reliability measures (95% CI) using the clinical diagnosis as a gold standard and a dichotomized result of the smell test into high (50% or more) or low (<50%) “PD probability” were: sensitivity 85.0% (78.8–89.7%), specificity 84.6% (77.3–89.9%) for the UPSIT‐40; sensitivity 90.4% (83.5–94.7%), specificity 85.5% (76.2–91.7%) for the SS‐16. Based on these findings we have created color coded visual tools (PD probability rulers) and applied them to 39 clinically uncertain parkinsonian syndromes (CUPS) patients who had been investigated with dopamine transporter SPECT scanning using [123‐I]‐FP‐CIT SPECT (DaTSCAN) for suspected Parkinson's disease. In 32 of 36 CUPS cases (88.9%, kappa = 0.72) the probability ruler predicted the result of the DaTSCAN. We suggest smell tests could be used routinely in challenging cases where there is diagnostic uncertainty and help inform decision making relating to the need for neuro imaging. © 2009 Movement Disorder Society
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DOI: 10.1002/mds.22494
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We have applied the 40 item University of Pennsylvania SIT (UPSIT‐40) and/or the 16 item SIT from Sniffin Sticks (SS‐16) to 193 nondemented PD patients and 157 controls and used logistic regression analysis to associate the SIT result with the probability of an individual patient having PD (“PD probability”). Reliability measures (95% CI) using the clinical diagnosis as a gold standard and a dichotomized result of the smell test into high (50% or more) or low (<50%) “PD probability” were: sensitivity 85.0% (78.8–89.7%), specificity 84.6% (77.3–89.9%) for the UPSIT‐40; sensitivity 90.4% (83.5–94.7%), specificity 85.5% (76.2–91.7%) for the SS‐16. Based on these findings we have created color coded visual tools (PD probability rulers) and applied them to 39 clinically uncertain parkinsonian syndromes (CUPS) patients who had been investigated with dopamine transporter SPECT scanning using [123‐I]‐FP‐CIT SPECT (DaTSCAN) for suspected Parkinson's disease. In 32 of 36 CUPS cases (88.9%, kappa = 0.72) the probability ruler predicted the result of the DaTSCAN. We suggest smell tests could be used routinely in challenging cases where there is diagnostic uncertainty and help inform decision making relating to the need for neuro imaging. © 2009 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Laura Silveira‐Moriyama MD</name><affiliations><json:string>Reta Lila Weston Institute of Neurological Studies, UCL Institute of Neurology, London, United Kingdom</json:string></affiliations></json:item><json:item><name>Aviva Petrie MSc, CStat</name><affiliations><json:string>Biostatistics Unit, UCL Eastman Dental Institute, London, United Kingdom</json:string></affiliations></json:item><json:item><name>David R. 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We have applied the 40 item University of Pennsylvania SIT (UPSIT‐40) and/or the 16 item SIT from Sniffin Sticks (SS‐16) to 193 nondemented PD patients and 157 controls and used logistic regression analysis to associate the SIT result with the probability of an individual patient having PD (“PD probability”). Reliability measures (95% CI) using the clinical diagnosis as a gold standard and a dichotomized result of the smell test into high (50% or more) or low (>50%) “PD probability” were: sensitivity 85.0% (78.8–89.7%), specificity 84.6% (77.3–89.9%) for the UPSIT‐40; sensitivity 90.4% (83.5–94.7%), specificity 85.5% (76.2–91.7%) for the SS‐16. Based on these findings we have created color coded visual tools (PD probability rulers) and applied them to 39 clinically uncertain parkinsonian syndromes (CUPS) patients who had been investigated with dopamine transporter SPECT scanning using [123‐I]‐FP‐CIT SPECT (DaTSCAN) for suspected Parkinson's disease. In 32 of 36 CUPS cases (88.9%, kappa = 0.72) the probability ruler predicted the result of the DaTSCAN. We suggest smell tests could be used routinely in challenging cases where there is diagnostic uncertainty and help inform decision making relating to the need for neuro imaging. © 2009 Movement Disorder Society</abstract><qualityIndicators><score>7.433</score><pdfVersion>1.3</pdfVersion><pdfPageSize>612 x 810 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>7</keywordCount><abstractCharCount>1401</abstractCharCount><pdfWordCount>4925</pdfWordCount><pdfCharCount>32310</pdfCharCount><pdfPageCount>10</pdfPageCount><abstractWordCount>209</abstractWordCount></qualityIndicators><title>The use of a color coded probability scale to interpret smell tests in suspected parkinsonism</title><genre><json:string>article</json:string></genre><host><volume>24</volume><publisherId><json:string>MDS</json:string></publisherId><pages><total>10</total><last>1153</last><first>1144</first></pages><issn><json:string>0885-3185</json:string></issn><issue>8</issue><subject><json:item><value>Research Article</value></json:item></subject><genre><json:string>Journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1531-8257</json:string></eissn><title>Movement Disorders</title><doi><json:string>10.1002/(ISSN)1531-8257</json:string></doi></host><publicationDate>2009</publicationDate><copyrightDate>2009</copyrightDate><doi><json:string>10.1002/mds.22494</json:string></doi><id>386DC157AC17BE187549766AACB8CA1EB5167F16</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/386DC157AC17BE187549766AACB8CA1EB5167F16/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/386DC157AC17BE187549766AACB8CA1EB5167F16/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/386DC157AC17BE187549766AACB8CA1EB5167F16/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">The use of a color coded probability scale to interpret smell tests in suspected parkinsonism</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><availability><p>WILEY</p></availability><date>2009</date></publicationStmt><notesStmt><note type="content">*Significant at 5% level.</note><note>Reta Lila Weston Trust for Neurological Studies</note><note>Dr. Silveira‐Moriyama is a beneficiary of a RLW fellowship</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">The use of a color coded probability scale to interpret smell tests in suspected parkinsonism</title><author><persName><forename type="first">Laura</forename><surname>Silveira‐Moriyama</surname></persName><roleName type="degree">MD</roleName><affiliation>Reta Lila Weston Institute of Neurological Studies, UCL Institute of Neurology, London, United Kingdom</affiliation></author><author><persName><forename type="first">Aviva</forename><surname>Petrie</surname></persName><roleName type="degree">MSc, CStat</roleName><affiliation>Biostatistics Unit, UCL Eastman Dental Institute, London, United Kingdom</affiliation></author><author><persName><forename type="first">David R.</forename><surname>Williams</surname></persName><roleName type="degree">FRACP</roleName><affiliation>Faculty of Medicine (Neurosciences), Monash University, Melbourne, Australia</affiliation></author><author><persName><forename type="first">Andrew</forename><surname>Evans</surname></persName><roleName type="degree">FRACP</roleName><affiliation>Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia</affiliation></author><author><persName><forename type="first">Regina</forename><surname>Katzenschlager</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Neurology, Donauspital/Sozialmedizinisches Zentrum Ost, Vienna, Austria</affiliation></author><author><persName><forename type="first">Egberto R.</forename><surname>Barbosa</surname></persName><roleName type="degree">MD</roleName><affiliation>Neurology Department, Sao Paulo School of Medicine, Sao Paulo, Brazil</affiliation></author><author><persName><forename type="first">Andrew J.</forename><surname>Lees</surname></persName><roleName type="degree">MD</roleName><note type="correspondence"><p>Correspondence: Reta Lila Weston Institute of Neurological Studies, UCL Institute of Neurology, 1 Wakefield Street, London, WC1N 1PJ, United Kingdom</p></note><affiliation>Reta Lila Weston Institute of Neurological Studies, UCL Institute of Neurology, London, United Kingdom</affiliation></author></analytic><monogr><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. 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We have applied the 40 item University of Pennsylvania SIT (UPSIT‐40) and/or the 16 item SIT from Sniffin Sticks (SS‐16) to 193 nondemented PD patients and 157 controls and used logistic regression analysis to associate the SIT result with the probability of an individual patient having PD (“PD probability”). Reliability measures (95% CI) using the clinical diagnosis as a gold standard and a dichotomized result of the smell test into high (50% or more) or low (<50%) “PD probability” were: sensitivity 85.0% (78.8–89.7%), specificity 84.6% (77.3–89.9%) for the UPSIT‐40; sensitivity 90.4% (83.5–94.7%), specificity 85.5% (76.2–91.7%) for the SS‐16. Based on these findings we have created color coded visual tools (PD probability rulers) and applied them to 39 clinically uncertain parkinsonian syndromes (CUPS) patients who had been investigated with dopamine transporter SPECT scanning using [123‐I]‐FP‐CIT SPECT (DaTSCAN) for suspected Parkinson's disease. In 32 of 36 CUPS cases (88.9%, kappa = 0.72) the probability ruler predicted the result of the DaTSCAN. We suggest smell tests could be used routinely in challenging cases where there is diagnostic uncertainty and help inform decision making relating to the need for neuro imaging. © 2009 Movement Disorder Society</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>Parkinson's disease</term></item><item><term>parkinsonism</term></item><item><term>DaTSCAN</term></item><item><term>UPSIT</term></item><item><term>sniffin'</term></item><item><term>sticks</term></item><item><term>olfaction</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>article category</head><item><term>Research Article</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2008-10-21">Received</change><change when="2009-01-18">Registration</change><change when="2009-06-15">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/386DC157AC17BE187549766AACB8CA1EB5167F16/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>Hoboken</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-8257</doi><issn type="print">0885-3185</issn><issn type="electronic">1531-8257</issn><idGroup><id type="product" value="MDS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="MOVEMENT DISORDERS">Movement Disorders</title><title type="short">Mov. 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J.</givenNames><familyName>Lees</familyName><degrees>MD</degrees></personName><contactDetails><email>alees@ion.ucl.ac.uk</email></contactDetails></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="GB" type="organization"><unparsedAffiliation>Reta Lila Weston Institute of Neurological Studies, UCL Institute of Neurology, London, United Kingdom</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="GB" type="organization"><unparsedAffiliation>Biostatistics Unit, UCL Eastman Dental Institute, London, United Kingdom</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="AU" type="organization"><unparsedAffiliation>Faculty of Medicine (Neurosciences), Monash University, Melbourne, Australia</unparsedAffiliation></affiliation><affiliation xml:id="af4" countryCode="AU" type="organization"><unparsedAffiliation>Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia</unparsedAffiliation></affiliation><affiliation xml:id="af5" countryCode="AT" type="organization"><unparsedAffiliation>Department of Neurology, Donauspital/Sozialmedizinisches Zentrum Ost, Vienna, Austria</unparsedAffiliation></affiliation><affiliation xml:id="af6" countryCode="BR" type="organization"><unparsedAffiliation>Neurology Department, Sao Paulo School of Medicine, Sao Paulo, Brazil</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">Parkinson's disease</keyword><keyword xml:id="kwd2">parkinsonism</keyword><keyword xml:id="kwd3">DaTSCAN</keyword><keyword xml:id="kwd4">UPSIT</keyword><keyword xml:id="kwd5">sniffin'</keyword><keyword xml:id="kwd6">sticks</keyword><keyword xml:id="kwd7">olfaction</keyword></keywordGroup><fundingInfo><fundingAgency>Reta Lila Weston Trust for Neurological Studies</fundingAgency></fundingInfo><fundingInfo><fundingAgency>Dr. Silveira‐Moriyama is a beneficiary of a RLW fellowship</fundingAgency></fundingInfo><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>Smell identification tests (SITs) have been suggested as useful in the differential diagnosis of Parkinson's disease (PD). We have applied the 40 item University of Pennsylvania SIT (UPSIT‐40) and/or the 16 item SIT from Sniffin Sticks (SS‐16) to 193 nondemented PD patients and 157 controls and used logistic regression analysis to associate the SIT result with the probability of an individual patient having PD (“PD probability”). Reliability measures (95% CI) using the clinical diagnosis as a gold standard and a dichotomized result of the smell test into high (50% or more) or low (<50%) “PD probability” were: sensitivity 85.0% (78.8–89.7%), specificity 84.6% (77.3–89.9%) for the UPSIT‐40; sensitivity 90.4% (83.5–94.7%), specificity 85.5% (76.2–91.7%) for the SS‐16. Based on these findings we have created color coded visual tools (PD probability rulers) and applied them to 39 clinically uncertain parkinsonian syndromes (CUPS) patients who had been investigated with dopamine transporter SPECT scanning using [123‐I]‐FP‐CIT SPECT (DaTSCAN) for suspected Parkinson's disease. In 32 of 36 CUPS cases (88.9%, kappa = 0.72) the probability ruler predicted the result of the DaTSCAN. We suggest smell tests could be used routinely in challenging cases where there is diagnostic uncertainty and help inform decision making relating to the need for neuro imaging. © 2009 Movement Disorder Society</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn2" numbered="no"><p>Potential conflict of interest: None reported.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>The use of a color coded probability scale to interpret smell tests in suspected parkinsonism</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Interpreting Smell Tests in Parkinsonism</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>The use of a color coded probability scale to interpret smell tests in suspected parkinsonism</title></titleInfo><name type="personal"><namePart type="given">Laura</namePart><namePart type="family">Silveira‐Moriyama</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Reta Lila Weston Institute of Neurological Studies, UCL Institute of Neurology, London, United Kingdom</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Aviva</namePart><namePart type="family">Petrie</namePart><namePart type="termsOfAddress">MSc, CStat</namePart><affiliation>Biostatistics Unit, UCL Eastman Dental Institute, London, United Kingdom</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">David R.</namePart><namePart type="family">Williams</namePart><namePart type="termsOfAddress">FRACP</namePart><affiliation>Faculty of Medicine (Neurosciences), Monash University, Melbourne, Australia</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Andrew</namePart><namePart type="family">Evans</namePart><namePart type="termsOfAddress">FRACP</namePart><affiliation>Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Regina</namePart><namePart type="family">Katzenschlager</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, Donauspital/Sozialmedizinisches Zentrum Ost, Vienna, Austria</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Egberto R.</namePart><namePart type="family">Barbosa</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Neurology Department, Sao Paulo School of Medicine, Sao Paulo, Brazil</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Andrew J.</namePart><namePart type="family">Lees</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Reta Lila Weston Institute of Neurological Studies, UCL Institute of Neurology, London, United Kingdom</affiliation><description>Correspondence: Reta Lila Weston Institute of Neurological Studies, UCL Institute of Neurology, 1 Wakefield Street, London, WC1N 1PJ, United Kingdom</description><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2009-06-15</dateIssued><dateCaptured encoding="w3cdtf">2008-10-21</dateCaptured><dateValid encoding="w3cdtf">2009-01-18</dateValid><copyrightDate encoding="w3cdtf">2009</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">4</extent><extent unit="tables">2</extent><extent unit="references">50</extent><extent unit="words">6687</extent></physicalDescription><abstract lang="en">Smell identification tests (SITs) have been suggested as useful in the differential diagnosis of Parkinson's disease (PD). We have applied the 40 item University of Pennsylvania SIT (UPSIT‐40) and/or the 16 item SIT from Sniffin Sticks (SS‐16) to 193 nondemented PD patients and 157 controls and used logistic regression analysis to associate the SIT result with the probability of an individual patient having PD (“PD probability”). Reliability measures (95% CI) using the clinical diagnosis as a gold standard and a dichotomized result of the smell test into high (50% or more) or low (<50%) “PD probability” were: sensitivity 85.0% (78.8–89.7%), specificity 84.6% (77.3–89.9%) for the UPSIT‐40; sensitivity 90.4% (83.5–94.7%), specificity 85.5% (76.2–91.7%) for the SS‐16. Based on these findings we have created color coded visual tools (PD probability rulers) and applied them to 39 clinically uncertain parkinsonian syndromes (CUPS) patients who had been investigated with dopamine transporter SPECT scanning using [123‐I]‐FP‐CIT SPECT (DaTSCAN) for suspected Parkinson's disease. In 32 of 36 CUPS cases (88.9%, kappa = 0.72) the probability ruler predicted the result of the DaTSCAN. We suggest smell tests could be used routinely in challenging cases where there is diagnostic uncertainty and help inform decision making relating to the need for neuro imaging. © 2009 Movement Disorder Society</abstract><note type="content">*Significant at 5% level.</note><note type="funding">Reta Lila Weston Trust for Neurological Studies</note><note type="funding">Dr. Silveira‐Moriyama is a beneficiary of a RLW fellowship</note><subject lang="en"><genre>Keywords</genre><topic>Parkinson's disease</topic><topic>parkinsonism</topic><topic>DaTSCAN</topic><topic>UPSIT</topic><topic>sniffin'</topic><topic>sticks</topic><topic>olfaction</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title></titleInfo><titleInfo type="abbreviated"><title>Mov. Disord.</title></titleInfo><genre type="Journal">journal</genre><subject><genre>article category</genre><topic>Research Article</topic></subject><identifier type="ISSN">0885-3185</identifier><identifier type="eISSN">1531-8257</identifier><identifier type="DOI">10.1002/(ISSN)1531-8257</identifier><identifier type="PublisherID">MDS</identifier><part><date>2009</date><detail type="volume"><caption>vol.</caption><number>24</number></detail><detail type="issue"><caption>no.</caption><number>8</number></detail><extent unit="pages"><start>1144</start><end>1153</end><total>10</total></extent></part></relatedItem><identifier type="istex">386DC157AC17BE187549766AACB8CA1EB5167F16</identifier><identifier type="DOI">10.1002/mds.22494</identifier><identifier type="ArticleID">MDS22494</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2009 Movement Disorder Society</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Wiley Subscription Services, Inc., A Wiley Company</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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