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Development and external validation of a prognostic model in newly diagnosed Parkinson disease.


ABSTRACT:

Objective

To develop a prognostic model to predict disease outcomes in individual patients with Parkinson disease (PD) and perform an external validation study in an independent cohort.

Methods

Model development was done in the Comorbidity and Aging in Rehabilitation Patients: The Influence on Activities (CARPA) cohort (Netherlands). External validation was performed using the Cambridgeshire Parkinson's Incidence from GP to Neurologist (CamPaIGN) cohort (UK). Both are longitudinal incident cohort studies that prospectively followed up patients with PD from the time of diagnosis. A composite outcome measure was made in which patients were classified as having an unfavorable prognosis when they had postural instability or dementia at the 5-year assessment (or at the last assessment before loss to follow-up), or had died before this time. The final model was derived with a backward selection strategy from candidate predictor variables that were measured at baseline.

Results

In the resulting model, higher patient age, higher Unified Parkinson's Disease Rating Scale motor examination axial score, and a lower animal fluency score were all associated with a higher probability of an unfavorable outcome. External validation confirmed good discriminative ability between favorable and unfavorable outcomes with an area under the receiver operating characteristic curve of 0.85 (95% confidence interval 0.77-0.93) and a well-calibrated model with a calibration slope of 1.13 and no significant lack of fit (Hosmer-Lemeshow test: p = 0.39).

Conclusion

We constructed a model that allows individual patient prognostication at 5 years from diagnosis, using a small set of predictor variables that can easily be obtained by clinicians or research nurses.

SUBMITTER: Velseboer DC 

PROVIDER: S-EPMC4799715 | biostudies-literature | 2016 Mar

REPOSITORIES: biostudies-literature

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Publications

Development and external validation of a prognostic model in newly diagnosed Parkinson disease.

Velseboer Daan C DC   de Bie Rob M A RM   Wieske Luuk L   Evans Jonathan R JR   Mason Sarah L SL   Foltynie Thomas T   Schmand Ben B   de Haan Rob J RJ   Post Bart B   Barker Roger A RA   Williams-Gray Caroline H CH  

Neurology 20160217 11


<h4>Objective</h4>To develop a prognostic model to predict disease outcomes in individual patients with Parkinson disease (PD) and perform an external validation study in an independent cohort.<h4>Methods</h4>Model development was done in the Comorbidity and Aging in Rehabilitation Patients: The Influence on Activities (CARPA) cohort (Netherlands). External validation was performed using the Cambridgeshire Parkinson's Incidence from GP to Neurologist (CamPaIGN) cohort (UK). Both are longitudinal  ...[more]

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