帕金森病家庭日记和观察员评估在结构化患者培训前后的一致性

IF 2.9 3区 医学 Q2 CLINICAL NEUROLOGY
Carin Janz, Jonathan Timpka, Matthias Löhle, Alexander Bremer, Florin Gandor, Georg Ebersbach, Alexander Storch, Per Odin
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引用次数: 0

摘要

目标。最近的研究表明,观察者和患者对帕金森病(PD)家庭日记(HD)的运动状态评估之间只有公平的一致性。这可能是因为患者对运动波动的了解不足。因此,本研究旨在调查与运动波动有关的结构化训练对观察者和HD评分以及日常运动状态时间之间一致性的影响。方法。先前HD验证研究的参与者被邀请回来进行研究扩展。这项介入研究包括一次筛查访问,包括一次关于运动波动的结构化培训和一天的现场运动评分,在此期间,观察者和患者每半小时同时独立评估患者的运动状态。后果观察者和20名患者完成了316对运动状态评估。训练前和训练后的总体一致性分别为68%和76%(P=.093),Cohen的κ从.438增加到.559(P=.320)。与观察者评分相比,HD记录的每日运动状态时间的相关性/可靠性没有显著改善。此外,在训练前,观察到的“运动障碍”的一致性为58%,训练后为80%(P=.074)。结论我们对运动波动的结构化患者训练并没有显著提高观察者和HD之间的一致性,也没有显著提高在不同运动状态下每天花费的时间作为该PD患者组HD的综合衡量标准的可靠性。然而,有迹象表明,参与者检测运动障碍的能力有所提高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Agreement between Parkinson Disease Home Diary and Observer Assessments before and after Structured Patient Training

Agreement between Parkinson Disease Home Diary and Observer Assessments before and after Structured Patient Training

Objectives. Recent studies showed only fair agreement between observer and patients’ motor state assessments on the Parkinson’s disease (PD) home diary (HD). This could possibly be explained by the patients’ insufficient knowledge about motor fluctuations. Therefore, the study is aimed at investigating the effect of structured training concerning motor fluctuations on the agreement between observer and HD ratings and daily motor state times. Methods. Participants from a previous validation study of the HD were invited back for a study extension. This interventional study consisted of a screening visit including a structured training concerning motor fluctuations and one day of motor ratings onsite during which observer and patient simultaneously and independently evaluated the patient’s motor state every half hour. Results. Observer and 20 patients completed 316 pairs of motor state assessments. The overall agreement was 68% before training and 76% after training (P = .093) and Cohen’s κ increased from .438 to .559 (P = .320). There was no significant improvement in the correlation/reliability of HD-documented daily motor state time when compared with observer ratings. Moreover, before training, the agreement in observed “on with dyskinesias” was 58%, and after training, it was 80% (P = .074). Conclusion. Our structured patient training in motor fluctuations did not significantly improve the agreement between observer and HD or the reliability of daily times spent in the different motor states as an aggregate measure of HD in this PD patient group. However, there are indications of an improvement in the participants’ ability to detect dyskinesias.

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来源期刊
Acta Neurologica Scandinavica
Acta Neurologica Scandinavica 医学-临床神经学
CiteScore
6.70
自引率
2.90%
发文量
161
审稿时长
4-8 weeks
期刊介绍: Acta Neurologica Scandinavica aims to publish manuscripts of a high scientific quality representing original clinical, diagnostic or experimental work in neuroscience. The journal''s scope is to act as an international forum for the dissemination of information advancing the science or practice of this subject area. Papers in English will be welcomed, especially those which bring new knowledge and observations from the application of therapies or techniques in the combating of a broad spectrum of neurological disease and neurodegenerative disorders. Relevant articles on the basic neurosciences will be published where they extend present understanding of such disorders. Priority will be given to review of topical subjects. Papers requiring rapid publication because of their significance and timeliness will be included as ''Clinical commentaries'' not exceeding two printed pages, as will ''Clinical commentaries'' of sufficient general interest. Debate within the speciality is encouraged in the form of ''Letters to the editor''. All submitted manuscripts falling within the overall scope of the journal will be assessed by suitably qualified referees.
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