Consensus on the definition of advanced parkinson's disease: a neurologists-based Delphi study (CEPA Study)

To date, no consensus exists on the key factors for diagnosing advanced Parkinson disease (APD). To obtain consensus on the definition of APD, we performed a prospective, multicenter, Spanish nationwide, 3-round Delphi study (CEPA study). An ad hoc questionnaire was designed with 33 questions concer...

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Bibliographic Details
Authors: Luquin, Maria Rosario, Kulisevsky, Jaime, Martínez Martín, Pablo, Mir Rivera, Pablo, Tolosa Sarró, Eduard
Format: article
Status:Published version
Publication Date:2017
Country:España
Institution:Universitat Oberta de Catalunya (UOC)
Repository:O2, repositorio institucional de la UOC
OAI Identifier:oai:openaccess.uoc.edu:10609/93082
Online Access:https://hdl.handle.net/10609/93082
Access Level:Open access
Keyword:malaltia de Parkinson
neurodegeneració
enfermedad de Parkinson
neurodegeneración
Parkinson's disease
neurodegeneration
Neurology
Neurologia
Neurología
Description
Summary:To date, no consensus exists on the key factors for diagnosing advanced Parkinson disease (APD). To obtain consensus on the definition of APD, we performed a prospective, multicenter, Spanish nationwide, 3-round Delphi study (CEPA study). An ad hoc questionnaire was designed with 33 questions concerning the relevance of several clinical features for APD diagnosis. In the first-round, 240 neurologists of the Spanish Movement Disorders Group participated in the study. The results obtained were incorporated into the questionnaire and both, results and questionnaire, were sent out to and fulfilled by 26 experts in Movement Disorders. Review of results from the second-round led to a classification of symptoms as indicative of "definitive," "probable," and "possible" APD. This classification was confirmed by 149 previous participating neurologists in a third-round, where 92% completely or very much agreed with the classification. Definitive symptoms of APD included disability requiring help for the activities of daily living, presence of motor fluctuations with limitations to perform basic activities of daily living without help, severe dysphagia, recurrent falls, and dementia. These results will help neurologists to identify some key factors in APD diagnosis, thus allowing users to categorize the patients for a homogeneous recognition of this condition.