Parkinson's disease case ascertainment in a large prospective cohort.
Parkinson's disease case ascertainment in a large prospective cohort.
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DOI：
10.1371/journal.pone.0251852
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Sandler DP
中科院分区：
文献类型：
--
作者：
Shrestha S;Parks CG;Richards-Barber M;Chen H;Sandler DP
在流行病学研究中，基于医生的病例裁决是不可行的，帕金森病（PD）的病例确定往往限于自我报告，这可能是不准确的。我们评估了在农业健康研究（AHS）中识别PD病例的策略。在所有队列调查中，医生诊断的PD都是自我报告的；还从死亡证明中确定了潜在病例。随访调查询问pd相关的运动和非运动症状。对于帕金森病的确诊，我们收集了额外的诊断、症状和治疗数据，这些数据来自510名潜在的帕金森病患者或他们的代理人（65%的接触者），并获得了一个子集（n = 65）的医疗记录。我们使用既定标准和筛选数据对PD病例进行分类。在510例潜在PD病例中，75%被认为是“可能的”或“可能的”；在专家诊断（81.2%）、服用PD药物（85.2%）或在常规AHS调查中报告≥5种运动症状（86.8%）的参与者中，这一比例增加。在有医疗记录的患者中，93%（61人中57人）确诊为可能或可能的PD。先前AHS调查中报告的从不吸烟和非运动和运动症状在可能/可能的PD中比未确诊的PD更常见。在这项回顾性PD病例确定工作中，我们发现，当医生检查不可行时，PD自我报告与运动症状或药物信息可能是识别PD病例的合理选择。由于干预死亡率，约三分之一的接触者无法获得筛查结果。因此，研究结果值得重复。
In epidemiologic studies where physician-based case adjudication is not feasible, Parkinson’s disease (PD) case ascertainment is often limited to self-reports which may not be accurate. We evaluated strategies to identify PD cases in the Agricultural Health Study (AHS). Doctor-diagnosed PD was self-reported on all cohort-wide surveys; potential cases were also identified from death certificates. Follow-up surveys asked about PD-related motor and non-motor symptoms. For PD confirmation, we collected additional diagnosis, symptom, and treatment data from 510 potential PD cases or their proxy (65% of those contacted) in a supplemental screener and obtained medical records for a subset (n = 65). We classified PD cases using established criteria and screener data. Of 510 potential PD cases, 75% were considered “probable” or “possible”; this proportion increased among participants diagnosed by a specialist (81.2%), taking PD medication (85.2%), or reporting ≥5 motor symptoms (86.8%) in a regular AHS survey. Of those with medical records, 93% (57 of 61) of probable or possible PD was confirmed. Never-smoking and non-motor and motor symptoms reported in prior AHS surveys were more common with probable/possible PD than unconfirmed PD. In this retrospective PD case ascertainment effort, we found that PD self-report with information on motor symptoms or medications may be a reasonable alternative for identifying PD cases when physician exam is not feasible. Because of intervening mortality, screeners could not be obtained from about one-third of those contacted. Thus, findings warrant replication.
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DOI：
10.1111/j.1532-5415.2004.52021.x
发表时间：
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影响因子：
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作者：
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通讯作者：
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