Evaluating Parkinson's disease patients at home: utility of self-videotaping for objective motor, dyskinesia, and ON-OFF assessments.
The objective is to test feasibility and utility of home-based videos for assessing Parkinson's disease (PD) patients. As part of a clinical trial, patients opted between coming to the study sites or learning to videotape assessments at home. Those opting for at-home filming completed training on videotape techniques. Ten-minute films were taken at 30-minute intervals over 8.5 hours, 2 and 4 weeks after study entry using a protocol covering most items of the UDPRS motor examination and all Rush Dyskinesia Rating Scale items. After each filming, patients marked their ON/OFF status, based on prior training. We determined the number of patients who elected self-taping and the quality of video segments obtained. To assess ON/OFF patient accuracy, we compared the rater's and patient's assessment of ON/OFF at each time point. Of 12 participants, 10 elected self-videotaping and only 1 time point was missed (99.5% taping compliance). All self-recorded video segments were clear with all protocol elements included. With the exception of one missed ON/OFF rating, patient-based self-ratings occurred on time. Rating ON/OFF, UPDRS, and RDRS assessments for 8.5 hours required 170 minutes by the blinded rater. In spite of patient training, mean ON/OFF concordance between rater and patients was only 64%. At home video-based self-recordings are feasible and allow accurate rater-based ON/OFF assessments. In this group of patients with no or mild fluctuations, in spite of pretrial training, patients were inaccurate in separating ON vs. OFF status.
Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois 60612, USA. cgoetz@rush.edu
Christopher G
CG
Goetz
Sue
S
Leurgans
Vanessa K
VK
Hinson
Lucia M
LM
Blasucci
Jennifer
J
Zimmerman
Wenqing
W
Fan
Tiffany
T
Nguyen
Ann
A
Hsu
D000368:Aged; D000369:Aged, 80 and over; D000978:Antiparkinson Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D016903:Drug Monitoring / Q000379:methods*; D004409:Dyskinesia, Drug-Induced / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy / Q000503:physiopathology* / Q000523:psychology; D011597:Psychomotor Performance / Q000187:drug effects; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D012648:Self Care / Q000379:methods; D016037:Single-Blind Method; D014743:Videotape Recording
D000978:Antiparkinson Agents