Accuracy of Parkinson's disease diagnosis in 610 general practice patients in the West of Scotland
Identifieur interne : 000B76 ( Main/Exploration ); précédent : 000B75; suivant : 000B77Accuracy of Parkinson's disease diagnosis in 610 general practice patients in the West of Scotland
Auteurs : Edward J. Newman [Royaume-Uni] ; Kieran Breen [Royaume-Uni] ; Jim Patterson [Royaume-Uni] ; Donald M. Hadley [Royaume-Uni] ; Katherine A. Grosset [Royaume-Uni] ; Donald G. Grosset [Royaume-Uni]Source :
- Movement Disorders [ 0885-3185 ] ; 2009-12-15.
English descriptors
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; 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. © 2009 Movement Disorder Society
Url:
DOI: 10.1002/mds.22829
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><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></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">ISTEX</idno><idno type="RBID">ISTEX:16F587947B5CCE1D3743EB03829F810CE8C4E257</idno><date when="2009" year="2009">2009</date><idno type="doi">10.1002/mds.22829</idno><idno type="url">https://api.istex.fr/document/16F587947B5CCE1D3743EB03829F810CE8C4E257/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">001E96</idno><idno type="wicri:Area/Main/Curation">001C05</idno><idno type="wicri:Area/Main/Exploration">000B76</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" 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"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Neurology, Institute of Neurological Sciences, Southern General Hospital, Glasgow</wicri:regionArea><wicri:noRegion>Glasgow</wicri:noRegion></affiliation></author><author><name sortKey="Breen, Kieran" sort="Breen, Kieran" uniqKey="Breen K" first="Kieran" last="Breen">Kieran Breen</name><affiliation wicri:level="3"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Parkinson's Disease Society National Office, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Patterson, Jim" sort="Patterson, Jim" uniqKey="Patterson J" first="Jim" last="Patterson">Jim Patterson</name><affiliation wicri:level="1"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Clinical Physics, Institute of Neurological Sciences, Southern General Hospital, Glasgow</wicri:regionArea><wicri:noRegion>Glasgow</wicri:noRegion></affiliation></author><author><name sortKey="Hadley, Donald M" sort="Hadley, Donald M" uniqKey="Hadley D" first="Donald M." last="Hadley">Donald M. Hadley</name><affiliation wicri:level="1"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Neuroradiology, Institute of Neurological Sciences, Southern General Hospital, Glasgow</wicri:regionArea><wicri:noRegion>Glasgow</wicri:noRegion></affiliation></author><author><name sortKey="Grosset, Katherine A" sort="Grosset, Katherine A" uniqKey="Grosset K" first="Katherine A." last="Grosset">Katherine A. Grosset</name><affiliation wicri:level="1"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Neurology, Institute of Neurological Sciences, Southern General Hospital, Glasgow</wicri:regionArea><wicri:noRegion>Glasgow</wicri:noRegion></affiliation></author><author><name sortKey="Grosset, Donald G" sort="Grosset, Donald G" uniqKey="Grosset D" first="Donald G." last="Grosset">Donald G. Grosset</name><affiliation wicri:level="1"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Neurology, Institute of Neurological Sciences, Southern General Hospital, Glasgow</wicri:regionArea><wicri:noRegion>Glasgow</wicri:noRegion></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2009-12-15">2009-12-15</date><biblScope unit="volume">24</biblScope><biblScope unit="issue">16</biblScope><biblScope unit="page" from="2379">2379</biblScope><biblScope unit="page" to="2385">2385</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">16F587947B5CCE1D3743EB03829F810CE8C4E257</idno><idno type="DOI">10.1002/mds.22829</idno><idno type="ArticleID">MDS22829</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Parkinson's disease</term><term>diagnostic accuracy</term><term>medication withdrawal</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></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; 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. © 2009 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li></region><settlement><li>Londres</li></settlement></list><tree><country name="Royaume-Uni"><noRegion><name sortKey="Newman, Edward J" sort="Newman, Edward J" uniqKey="Newman E" first="Edward J." last="Newman">Edward J. Newman</name></noRegion><name sortKey="Breen, Kieran" sort="Breen, Kieran" uniqKey="Breen K" first="Kieran" last="Breen">Kieran Breen</name><name sortKey="Grosset, Donald G" sort="Grosset, Donald G" uniqKey="Grosset D" first="Donald G." last="Grosset">Donald G. Grosset</name><name sortKey="Grosset, Katherine A" sort="Grosset, Katherine A" uniqKey="Grosset K" first="Katherine A." last="Grosset">Katherine A. Grosset</name><name sortKey="Hadley, Donald M" sort="Hadley, Donald M" uniqKey="Hadley D" first="Donald M." last="Hadley">Donald M. Hadley</name><name sortKey="Patterson, Jim" sort="Patterson, Jim" uniqKey="Patterson J" first="Jim" last="Patterson">Jim Patterson</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/ParkinsonV1/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000B76 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 000B76 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Sante
|area= ParkinsonV1
|flux= Main
|étape= Exploration
|type= RBID
|clé= ISTEX:16F587947B5CCE1D3743EB03829F810CE8C4E257
|texte= Accuracy of Parkinson's disease diagnosis in 610 general practice patients in the West of Scotland
}}
| This area was generated with Dilib version V0.6.23. |  |