Robert R Coleman1, Vikas Kotagal2, Parag G Patil3, Kelvin L Chou4. 1. Department of Neurology, University of California San Francisco, San Francisco, CA ; Parkinson's Disease Research, Education, and Clinical Center, San Francisco Veteran's Affairs Medical Center, San Francisco, CA. 2. Department of Neurology, University of Michigan, Ann Arbor, MI. 3. Surgical Therapies Improving Movement Program, University of Michigan, Ann Arbor, MI ; Department of Neurosurgery, University of Michigan, Ann Arbor, MI. 4. Department of Neurology, University of Michigan, Ann Arbor, MI ; Surgical Therapies Improving Movement Program, University of Michigan, Ann Arbor, MI ; Department of Neurosurgery, University of Michigan, Ann Arbor, MI.
Abstract
BACKGROUND: Deep Brain Stimulation (DBS) for Parkinson disease (PD) may be underutilized because of limited access to care (most DBS surgeries are performed at specialized centers) or over-referral of poor candidates, leading to inequitable utilization of limited evaluative resources. There is a pressing need for a widely employable screening algorithm to aid in the evaluation of PD candidates for DBS. OBJECTIVE: To compare the validity and efficacy of two published screening algorithms, the Florida Surgical Questionnaire for PD and Stimulus, to predict candidacy for DBS. METHODS: We reviewed the clinical data at our DBS center for 147 consecutive PD DBS referrals between 9/1/2007 and 12/31/2011. Florida Surgical Questionnaire and Stimulus scores were applied retrospectively through a chart review of the Movement Disorder neurologist's initial clinical evaluation. The validity and accuracy of these two algorithms in predicting candidacy for DBS was compared to the decision to offer DBS surgery by our multidisciplinary DBS team. RESULTS: Of the 130 consecutive PD referrals who presented for initial evaluation, 50 were offered DBS after a standardized multidisciplinary evaluation. The Stimulus scale was a superior screening tool for predicting PD DBS candidacy in these referrals [Area under the Receiver operating curve = 0.8088] compared to the Florida Surgical Questionnaire for PD [Area under the Receiver operating curve = 0.6285]. CONCLUSION: In this single center study, Stimulus was a more appropriate screening measure than the Florida Surgical Questionnaire for PD to assess DBS candidacy for PD.
BACKGROUND: Deep Brain Stimulation (DBS) for Parkinson disease (PD) may be underutilized because of limited access to care (most DBS surgeries are performed at specialized centers) or over-referral of poor candidates, leading to inequitable utilization of limited evaluative resources. There is a pressing need for a widely employable screening algorithm to aid in the evaluation of PD candidates for DBS. OBJECTIVE: To compare the validity and efficacy of two published screening algorithms, the Florida Surgical Questionnaire for PD and Stimulus, to predict candidacy for DBS. METHODS: We reviewed the clinical data at our DBS center for 147 consecutive PD DBS referrals between 9/1/2007 and 12/31/2011. Florida Surgical Questionnaire and Stimulus scores were applied retrospectively through a chart review of the Movement Disorder neurologist's initial clinical evaluation. The validity and accuracy of these two algorithms in predicting candidacy for DBS was compared to the decision to offer DBS surgery by our multidisciplinary DBS team. RESULTS: Of the 130 consecutive PD referrals who presented for initial evaluation, 50 were offered DBS after a standardized multidisciplinary evaluation. The Stimulus scale was a superior screening tool for predicting PD DBS candidacy in these referrals [Area under the Receiver operating curve = 0.8088] compared to the Florida Surgical Questionnaire for PD [Area under the Receiver operating curve = 0.6285]. CONCLUSION: In this single center study, Stimulus was a more appropriate screening measure than the Florida Surgical Questionnaire for PD to assess DBS candidacy for PD.
Entities:
Keywords:
Parkinson disease; appropriateness; deep brain stimulation; referrals; screening tools
Authors: Michael S Okun; Michele Tagliati; Michael Pourfar; Hubert H Fernandez; Ramon L Rodriguez; Ron L Alterman; Kelly D Foote Journal: Arch Neurol Date: 2005-06-13
Authors: Jeff M Bronstein; Michele Tagliati; Ron L Alterman; Andres M Lozano; Jens Volkmann; Alessandro Stefani; Fay B Horak; Michael S Okun; Kelly D Foote; Paul Krack; Rajesh Pahwa; Jaimie M Henderson; Marwan I Hariz; Roy A Bakay; Ali Rezai; William J Marks; Elena Moro; Jerrold L Vitek; Frances M Weaver; Robert E Gross; Mahlon R DeLong Journal: Arch Neurol Date: 2010-10-11
Authors: M S Okun; H H Fernandez; O Pedraza; M Misra; K E Lyons; R Pahwa; D Tarsy; L Scollins; K Corapi; G M Friehs; J Grace; J Romrell; K D Foote Journal: Neurology Date: 2004-07-13 Impact factor: 9.910
Authors: W M M Schuepbach; J Rau; K Knudsen; J Volkmann; P Krack; L Timmermann; T D Hälbig; H Hesekamp; S M Navarro; N Meier; D Falk; M Mehdorn; S Paschen; M Maarouf; M T Barbe; G R Fink; A Kupsch; D Gruber; G-H Schneider; E Seigneuret; A Kistner; P Chaynes; F Ory-Magne; C Brefel Courbon; J Vesper; A Schnitzler; L Wojtecki; J-L Houeto; B Bataille; D Maltête; P Damier; S Raoul; F Sixel-Doering; D Hellwig; A Gharabaghi; R Krüger; M O Pinsker; F Amtage; J-M Régis; T Witjas; S Thobois; P Mertens; M Kloss; A Hartmann; W H Oertel; B Post; H Speelman; Y Agid; C Schade-Brittinger; G Deuschl Journal: N Engl J Med Date: 2013-02-14 Impact factor: 91.245
Authors: Christopher G Goetz; Barbara C Tilley; Stephanie R Shaftman; Glenn T Stebbins; Stanley Fahn; Pablo Martinez-Martin; Werner Poewe; Cristina Sampaio; Matthew B Stern; Richard Dodel; Bruno Dubois; Robert Holloway; Joseph Jankovic; Jaime Kulisevsky; Anthony E Lang; Andrew Lees; Sue Leurgans; Peter A LeWitt; David Nyenhuis; C Warren Olanow; Olivier Rascol; Anette Schrag; Jeanne A Teresi; Jacobus J van Hilten; Nancy LaPelle Journal: Mov Disord Date: 2008-11-15 Impact factor: 10.338
Authors: Shivanand P Lad; Paul S Kalanithi; Chirag G Patil; Parunut Itthimathin; Sara Batya; Helen Bronte-Stewart; Maxwell Boakye; Jaimie M Henderson Journal: Neuromodulation Date: 2010-07
Authors: Elena Moro; Michael Schüpbach; Tobias Wächter; Niels Allert; Roberto Eleopra; Christopher R Honey; Mauricio Rueda; Mya C Schiess; Yasushi Shimo; Peter Valkovic; Alan Whone; Herman Stoevelaar Journal: J Neurol Date: 2015-11-03 Impact factor: 4.849