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Use and interpretation of on/off diaries in Parkinson's disease.

Reimer, Jan LU ; Grabowski, Martin LU ; Lindvall, Olle LU and Hagell, Peter LU (2004) In Journal of Neurology, Neurosurgery and Psychiatry 75(3). p.396-400
Abstract
Objective: To explore the use and interpretation of self reported on/off diary data for assessment of daily motor fluctuations in Parkinson’s disease.



Methods: 26 consecutive non-demented patients with fluctuating Parkinson’s disease received standardised training on how to fill out the four category CAPSIT-PD on/off diary, followed by four hours of clinical observation and four weeks of daytime on/off diaries every 30 minutes at home.



Results: Overall patient–clinician agreement in diary entries was good ({kappa} = 0.62; weighted {kappa} = 0.84). Agreement for individual diary categories was good for "off" and "on with dyskinesias" ({kappa} = >=0.72), but moderate for "partial off" and "on"... (More)
Objective: To explore the use and interpretation of self reported on/off diary data for assessment of daily motor fluctuations in Parkinson’s disease.



Methods: 26 consecutive non-demented patients with fluctuating Parkinson’s disease received standardised training on how to fill out the four category CAPSIT-PD on/off diary, followed by four hours of clinical observation and four weeks of daytime on/off diaries every 30 minutes at home.



Results: Overall patient–clinician agreement in diary entries was good ({kappa} = 0.62; weighted {kappa} = 0.84). Agreement for individual diary categories was good for "off" and "on with dyskinesias" ({kappa} = >=0.72), but moderate for "partial off" and "on" ({kappa} = 0.49). The overall validity of patient kept diaries was supported by expected symptom severity variability across diary categories, as assessed in the clinic. One day’s home diary data failed to predict outcomes from the full four weeks for all diary categories, and data from three days failed to yield good prediction (predefined as R2 = >=~0.7) for the time spent in "off" and "partial off". Data from one week yielded good prediction (R2 = >=0.74) in all instances except "partial off", which could not be well predicted even when two weeks’ home diary data were considered (R2 = 0.52).



Conclusions: The data provide support for the overall accuracy and validity of the four category CAPSIT-PD on/off diary, but suggest that a three category diary format may improve accuracy and validity. Interpretation of diary data beyond the assessed time frame should be made with caution unless diaries have been kept for sufficiently long periods. (Less)
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organization
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type
Contribution to journal
publication status
published
subject
in
Journal of Neurology, Neurosurgery and Psychiatry
volume
75
issue
3
pages
396 - 400
publisher
BMJ Publishing Group
external identifiers
  • wos:000188970000012
  • pmid:14966154
  • scopus:1542407303
ISSN
1468-330X
DOI
10.1136/jnnp.2003.022780
language
English
LU publication?
yes
id
51184637-a377-4145-a01a-207f1fcd1bd3 (old id 120528)
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http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14966154&dopt=Abstract
date added to LUP
2007-07-06 11:01:56
date last changed
2017-09-10 04:41:59
@article{51184637-a377-4145-a01a-207f1fcd1bd3,
  abstract     = {Objective: To explore the use and interpretation of self reported on/off diary data for assessment of daily motor fluctuations in Parkinson’s disease.<br/><br>
<br/><br>
Methods: 26 consecutive non-demented patients with fluctuating Parkinson’s disease received standardised training on how to fill out the four category CAPSIT-PD on/off diary, followed by four hours of clinical observation and four weeks of daytime on/off diaries every 30 minutes at home.<br/><br>
<br/><br>
Results: Overall patient–clinician agreement in diary entries was good ({kappa} = 0.62; weighted {kappa} = 0.84). Agreement for individual diary categories was good for "off" and "on with dyskinesias" ({kappa} = &gt;=0.72), but moderate for "partial off" and "on" ({kappa} = 0.49). The overall validity of patient kept diaries was supported by expected symptom severity variability across diary categories, as assessed in the clinic. One day’s home diary data failed to predict outcomes from the full four weeks for all diary categories, and data from three days failed to yield good prediction (predefined as R2 = &gt;=~0.7) for the time spent in "off" and "partial off". Data from one week yielded good prediction (R2 = &gt;=0.74) in all instances except "partial off", which could not be well predicted even when two weeks’ home diary data were considered (R2 = 0.52).<br/><br>
<br/><br>
Conclusions: The data provide support for the overall accuracy and validity of the four category CAPSIT-PD on/off diary, but suggest that a three category diary format may improve accuracy and validity. Interpretation of diary data beyond the assessed time frame should be made with caution unless diaries have been kept for sufficiently long periods.},
  author       = {Reimer, Jan and Grabowski, Martin and Lindvall, Olle and Hagell, Peter},
  issn         = {1468-330X},
  language     = {eng},
  number       = {3},
  pages        = {396--400},
  publisher    = {BMJ Publishing Group},
  series       = {Journal of Neurology, Neurosurgery and Psychiatry},
  title        = {Use and interpretation of on/off diaries in Parkinson's disease.},
  url          = {http://dx.doi.org/10.1136/jnnp.2003.022780},
  volume       = {75},
  year         = {2004},
}