| Title: |
Clinical effectiveness |
| Authors: |
McGhee, D. J. M.; Royle, P. L.; Counsell, C. E.; Abbas, A.; Sethi, P.; Manku, L.; Narayan, A.; Clegg, K.; Bardai, A.; Brown, S. H. M.; Hafeez, U.; Abdelhafiz, A. H.; McGovern, A.; Breckenridge, A.; Seenan, P.; Samani, A.; Das, S.; Khan, S.; Puffett, A. J.; Morgan, J.; Ross, G.; Cantlay, A.; Khan, N.; Bhalla, A.; Sweeting, M.; Nimmo, C A M D; Fleet, J.; Igbedioh, C.; Harari, D.; Downey, C. L.; Handforth, C.; Stothard, C.; Cracknell, A.; Barnes, C.; Shaw, L.; Bainbridge, L.; Crabtree, L.; Clark, T.; Root, S.; Aitken, E.; Haroon, K.; Sudlow, M.; Hanley, K.; Welsh, S.; Hill, E.; Falconer, A.; Miller, H.; Martin, B.; Tidy, E.; Pendlebury, S.; Thompson, S.; Burnett, E.; Taylor, H.; Lonan, J.; Adler, B.; McCallion, J.; Sykes, E.; Bancroft, R.; Tullo, E. S.; Young, T. J.; Clift, E.; Flavin, B.; Roberts, H. C.; Sayer, A. A.; Belludi, G.; Aithal, S.; Verma, A.; Singh, I.; Barne, M.; Wilkinson, I.; Sakoane, R.; Singh, N.; Cottee, M.; Irani, T. S.; Martinovic, O.; Abdulla, A. J. J.; Riglin, J.; Husk, J.; Lowe, D.; Treml, J.; Vasilakis, J. N.; Buttery, A.; Reid, J.; Healy, P.; Grant-Casey, J.; Pendry, K.; Richards, J.; Singh, A.; Jarrett, D.; Hewitt, J.; Slevin, J.; Barwell, G.; Youde, J.; Kennedy, C.; Romero-Ortuno, R.; O'Shea, D.; Robinson, D.; Kenny, R. A.; O'Connell, J.; Topp, J. D.; Warburton, K.; Simpson, L.; Bryce, K.; Suntharalingam, S.; Grosser, K.; D'Silva, A.; Southern, L.; Bielawski, C.; Cook, L.; Sutton, G. M.; Flanagan, L.; Storr, A.; Charlton, L.; Kerr, S.; Robinson, L.; Shaw, F.; Finch, L. K.; Weerasuriya, N.; Walker, M.; Sahota, O.; Logan, P.; Brown, F.; Rossiter, F.; Baxter, M.; Mucci, E.; Brown, A.; Jackson, S. H. D.; de Savary, N.; Hasan, S.; Jones, H.; Birrell, J.; Hockley, J.; Hensey, N.; Meiring, R.; Athavale, N.; Simms, J.; Brown, S.; West, A.; Diem, P.; Davies, R.; Kings, R.; Coleman, H.; Stevens, D.; Campbell, C.; Hope, S.; Morris, A.; Ong, T.; Harwood, R.; Dasgupta, D.; Mitchell, S.; Dimmock, V.; Collin, F.; Wood, E.; Green, V.; Hendrickse-Welsh, N.; Eccles, J.; Beezer, J.; Garside, M.; Baxter, J. |
| Publisher Information: |
Oxford University Press |
| Publication Year: |
2013 |
| Collection: |
HighWire Press (Stanford University) |
| Subject Terms: |
abstracts |
| Description: |
Scope: Using surrogate outcome biomarkers as endpoints in Parkinson's disease (PD) trials may help differentiate symptomatic effects of putative neuroprotective agents from true disease-modification. We undertook a systematic review to assess what biomarkers for disease progression in PD exist. Search methods: MEDLINE and EMBASE (1950-2010) were searched using five search strategies (four based on keywords, one MeSH headings). Abstracts were assessed to select papers meriting review in full. Reference lists were reviewed to identify articles missed by the electronic search, which was validated by hand-searching. Studies of participants with idiopathic PD diagnosed by formal criteria or clearly described clinical means were included, regardless of participant age, disease duration, treatment or study design. We included studies of tests (including imaging, blood, CSF and neurophysiology) used to investigate disease progression. We looked for associations of the test result with clinical measures of disease progression - impairment, global cognitive function, disability, handicap, quality of life and survival. Associations to individual symptoms, parts of scoring systems, mood, disease duration, therapeutic complications and treatment status were excluded. Papers available in English and in full were included. Results: 183 studies were included: 163 (89%) cross-sectional, 20 (11%) longitudinal. The sensitivity of the electronic search was 71.4%; specificity 97.2%. Median longitudinal follow-up was 2.0 years (interquartile range 1.1 to 3.5). Included studies were generally of poor quality, cross-sectional with small numbers of participants, applied excessive entry criteria, had flawed methodologies, and inappropriate statistical analyses. Conclusions: We found insufficient evidence to recommend the use of any biomarker for disease progression in PD trials. Given the poor quality of included studies, we present a provisional ‘roadmap’ for conducting future disease progression biomarker studies. |
| Document Type: |
text |
| File Description: |
text/html |
| Language: |
English |
| Relation: |
http://ageing.oxfordjournals.org/cgi/content/short/42/suppl_2/ii5; http://dx.doi.org/10.1093/ageing/aft016 |
| DOI: |
10.1093/ageing/aft016 |
| Availability: |
http://ageing.oxfordjournals.org/cgi/content/short/42/suppl_2/ii5; https://doi.org/10.1093/ageing/aft016 |
| Rights: |
Copyright (C) 2013, British Geriatrics Society |
| Accession Number: |
edsbas.43B60B21 |
| Database: |
BASE |