Simple Screening Tool for Early Diagnosis of Advanced Parkinson Disease

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The CDEPA questionnaire identified advanced Parkinson disease in 63% vs 37.6% of patients with clinical judgment.
The CDEPA questionnaire identified advanced Parkinson disease in 63% vs 37.6% of patients with clinical judgment.

The Cuestionario De Enfermedad de Parkinson Avanzada (CDEPA) screening questionnaire shows a high sensitivity at detecting advanced Parkinson disease (PD), according to a study published in NPJ Parkisons Disease.

This observational, cross-sectional, multicenter study sought to test the validity of the CDEPA as a screening tool for advanced Parkinson disease. Between January 1, 2015, and July 8, 2016, 173 patients in various stages of Parkinson disease took part in the study at the Department of Neurology outpatient clinics at 24 hospitals in Spain. A total of 9.4% of participants were in stage 1, 33.3% in stage 2, 29.8% in stage 3, 22.2% in stage 4, and 5.3% in stage 5.

The CDEPA questionnaire identified advanced Parkinson disease in 109 patients (63%) while clinical judgment identified 65 (37.6%), making the agreement between the 2 moderate (kappa statistic 0.48; P <.001). Advanced vs non-advanced Parkinson disease was classified in 63 of 65 cases, with a 96.9% sensitivity and a 57.4% specificity. The positive predictive value was 57.8% and the negative predictive value was 96.9%, with 42.6% false positives and 3.1% false negatives. The overall diagnostic accuracy of the questionnaire was 72.3%.

Study investigators concluded that “the CDEPA questionnaire is quick and easy to administer, suggesting that it could be integrated in PD outpatient clinics as a useful tool for screening PD patients, particularly due to the high sensitivity observed when classifying the advanced stage of the disease. However, a large-scale study including more patients with PD will help provide more extensive data to support the external validity of this instrument.”

Reference

Martinez-Martin P, Kulisevsky J, Mir P, Tolosa E, García-Delgado P, Luquin MR. Validation of a simple screening tool for early diagnosis of advanced Parkinson's disease in daily practice: the CDEPA questionnaireNPJ Parkinsons Dis. 2018 Jul 2;4:20. doi: 10.1038/s41531-018-0056-2.

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