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Monday, January 18, 2016

20% WITH PARKINSON'S DISEASE ARE MISDIAGNOSED

Jan. 18, 2016

An extensive study, carried out over the last 25 years, has shown that around 20% of people diagnosed with Parkinson's Disease have been misdiagnosed. The expertise of the person making the diagnosis did not make a considerable difference. Twenty studies were assessed for the accuracy of diagnosing Parkinson's Disease.

The average accuracy of diagnosing Parkinson's Disease for these studies was only 80%. For clinical diagnosis performed by non-experts the accuracy of diagnosis was even less at 73% accuracy. Accuracy of clinical diagnosis performed by movement disorders experts rose from 79% at the initial assessment to 84% after a follow-up assessment. The average accuracy of diagnosis by movement disorders experts overall was 82%.

The accuracy of diagnosing Parkinson's Disease was found to have not significantly improved in the last 25 years. The overall validity of clinical diagnosis of Parkinson's Disease is far from satisfying. This is particularly true in the early stages of Parkinson's Disease, when the response to dopaminergic treatment is less defined and hallmarks of alternative diagnoses such as atypical Parkinsonism may not have emerged.

For more concerning the methods of diagnosing Parkinson's Disease go to : Diagnosis of Parkinson's Disease http://viartis.net/parkinsons.disease/diagnosis.htm

Reference : Neurology [2016] Jan 13 [Epub ahead of print] (G.Rizzo, M.Copetti, S.Arcuti, D. Martino, A.Fontana, G.Logroscino)

http://www.viartis.net/parkinsons.disease/news/160118.pdf mail@viartis.net
©2015 Viartis
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Complete abstract :

Accuracy of clinical diagnosis of Parkinson disease: A systematic review and meta-analysis.

Rizzo G1, Copetti M1, Arcuti S1, Martino D1, Fontana A1, Logroscino G2.

Author information

Abstract

OBJECTIVE:

To evaluate the diagnostic accuracy of clinical diagnosis of Parkinson disease (PD) reported in the last 25 years by a systematic review and meta-analysis.

METHODS:

We searched for articles published between 1988 and August 2014. Studies were included if reporting diagnostic parameters regarding clinical diagnosis of PD or crude data. The selected studies were subclassified based on different study setting, type of test diagnosis, and gold standard. Bayesian meta-analyses of available data were performed.

RESULTS:

We selected 20 studies, including 11 using pathologic examination as gold standard. Considering only these 11 studies, the pooled diagnostic accuracy was 80.6% (95% credible interval [CrI] 75.2%-85.3%). Accuracy was 73.8% (95% CrI 67.8%-79.6%) for clinical diagnosis performed mainly by nonexperts. Accuracy of clinical diagnosis performed by movement disorders experts rose from 79.6% (95% CrI 46%-95.1%) of initial assessment to 83.9% (95% CrI 69.7%-92.6%) of refined diagnosis after follow-up. Using UK Parkinson's Disease Society Brain Bank Research Center criteria, the pooled diagnostic accuracy was 82.7% (95% CrI 62.6%-93%).

CONCLUSION:

The overall validity of clinical diagnosis of PD is not satisfying. The accuracy did not significantly improve in the last 25 years, particularly in the early stages of disease, where response to dopaminergic treatment is less defined and hallmarks of alternative diagnoses such as atypical parkinsonism may not have emerged. Misclassification rate should be considered to calculate the sample size both in observational studies and randomized controlled trials. Imaging and biomarkers are urgently needed to improve the accuracy of clinical diagnosis in vivo.