Natural history and effectiveness of early detection of Parkinson’s disease: results from two community‐based programmes in Taiwan (KCIS no. 11)
Identifieur interne : 000D39 ( Main/Exploration ); précédent : 000D38; suivant : 000D40Natural history and effectiveness of early detection of Parkinson’s disease: results from two community‐based programmes in Taiwan (KCIS no. 11)
Auteurs : Horng-Huei Liou [Taïwan] ; Chia-Yun Wu [Taïwan] ; Yueh-Hsia Chiu [Taïwan] ; Amy Ming-Fang Yen [Taïwan] ; Rong-Chi Chen [Taïwan] ; Ta-Fu Chen [Taïwan] ; Chih-Chuan Chen [Taïwan] ; Yuarn-Chung Hwang [Taïwan] ; Ying-Rong Wen [Taïwan] ; Tony Hsiu-Hsi Chen [Taïwan]Source :
- Journal of Evaluation in Clinical Practice [ 1356-1294 ] ; 2008-04.
Abstract
Objectives The natural course of Parkinson’s disease (PD), as measured on the Hoehn‐Yahr (H‐Y) scale, and the impact that early detection would have on prognosis for those with the disease, has barely been addressed since the introduction of L‐dopa. This study aimed to elucidate the natural history of PD and effectiveness of early detection in reducing advanced disability and mortality. Method A total of 21 362 participants aged 40 years or older were invited to two community‐based programmes for the early detection of PD. The step‐by‐step annual progression rates from H‐Y stage I to stage IV or V, and cumulative survival rates, by the H‐Y scale, were estimated and applied to simulated data to assess the impact of different screening intervals upon stage at diagnosis and subsequent survival. Results The average duration in stages I, II and III was estimated as 2.83, 6.62 and 1.41 years, respectively. The average delay time before deteriorating into H‐Y stage III was 9.45 year. Application of these parameters to simulated model predicted a 36% (95% CI: 28–39%), 26% (95% CI: 20–32%) and 19% (95% CI: 13–24%) reduction in death for annual, 5‐yearly and 10‐yearly screening programmes, respectively. Conclusion The present study recommended a 5‐yearly screening programme, with 74% of PD cases prevented from progressing to H‐Y stage III or worse within 10 years of diagnosis, and leading to a corresponding 26% reduction in mortality.
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DOI: 10.1111/j.1365-2753.2007.00832.x
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xml:lang="fr">Taïwan</country><wicri:regionArea>Research Fellow, Institute of Preventive Medicine, College of Public Health, National Taiwan University, Taipei, and Research Fellow, Centre of Biostatistics Consultation, National Taiwan University, Taipei</wicri:regionArea><wicri:noRegion>Taipei</wicri:noRegion></affiliation></author><author><name sortKey="Chen, Rong Hi" sort="Chen, Rong Hi" uniqKey="Chen R" first="Rong-Chi" last="Chen">Rong-Chi Chen</name><affiliation wicri:level="1"><country xml:lang="fr">Taïwan</country><wicri:regionArea>Attending Physician, Department of Neurology, En Chu Kong Hospital, Taipei</wicri:regionArea><wicri:noRegion>Taipei</wicri:noRegion></affiliation></author><author><name sortKey="Chen, Ta U" sort="Chen, Ta U" uniqKey="Chen T" first="Ta-Fu" last="Chen">Ta-Fu Chen</name><affiliation wicri:level="1"><country xml:lang="fr">Taïwan</country><wicri:regionArea>Attending Physician, Department of Neurology, National Taiwan University Hospital, 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detection would have on prognosis for those with the disease, has barely been addressed since the introduction of L‐dopa. This study aimed to elucidate the natural history of PD and effectiveness of early detection in reducing advanced disability and mortality. Method A total of 21 362 participants aged 40 years or older were invited to two community‐based programmes for the early detection of PD. The step‐by‐step annual progression rates from H‐Y stage I to stage IV or V, and cumulative survival rates, by the H‐Y scale, were estimated and applied to simulated data to assess the impact of different screening intervals upon stage at diagnosis and subsequent survival. Results The average duration in stages I, II and III was estimated as 2.83, 6.62 and 1.41 years, respectively. The average delay time before deteriorating into H‐Y stage III was 9.45 year. Application of these parameters to simulated model predicted a 36% (95% CI: 28–39%), 26% (95% CI: 20–32%) and 19% (95% CI: 13–24%) reduction in death for annual, 5‐yearly and 10‐yearly screening programmes, respectively. Conclusion The present study recommended a 5‐yearly screening programme, with 74% of PD cases prevented from progressing to H‐Y stage III or worse within 10 years of diagnosis, and leading to a corresponding 26% reduction in mortality.</div></front></TEI><affiliations><list><country><li>Taïwan</li></country></list><tree><country name="Taïwan"><noRegion><name sortKey="Liou, Horng Uei" sort="Liou, Horng Uei" uniqKey="Liou H" first="Horng-Huei" last="Liou">Horng-Huei Liou</name></noRegion><name sortKey="Chen, Chih Huan" sort="Chen, Chih Huan" uniqKey="Chen C" first="Chih-Chuan" last="Chen">Chih-Chuan Chen</name><name sortKey="Chen, Rong Hi" sort="Chen, Rong Hi" uniqKey="Chen R" first="Rong-Chi" last="Chen">Rong-Chi Chen</name><name sortKey="Chen, Ta U" sort="Chen, Ta U" uniqKey="Chen T" first="Ta-Fu" last="Chen">Ta-Fu Chen</name><name sortKey="Chen, Tony Hsiu Si" sort="Chen, Tony Hsiu Si" uniqKey="Chen T" first="Tony Hsiu-Hsi" last="Chen">Tony Hsiu-Hsi Chen</name><name sortKey="Chiu, Yueh Sia" sort="Chiu, Yueh Sia" uniqKey="Chiu Y" first="Yueh-Hsia" last="Chiu">Yueh-Hsia Chiu</name><name sortKey="Hwang, Yuarn Hung" sort="Hwang, Yuarn Hung" uniqKey="Hwang Y" first="Yuarn-Chung" last="Hwang">Yuarn-Chung Hwang</name><name sortKey="Wen, Ying Ong" sort="Wen, Ying Ong" uniqKey="Wen Y" first="Ying-Rong" last="Wen">Ying-Rong Wen</name><name sortKey="Wu, Chia Un" sort="Wu, Chia Un" uniqKey="Wu C" first="Chia-Yun" last="Wu">Chia-Yun Wu</name><name sortKey="Yen, Amy Ming Ang" sort="Yen, Amy Ming Ang" uniqKey="Yen A" first="Amy Ming-Fang" last="Yen">Amy Ming-Fang Yen</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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