title: Selection of deep brain stimulation candidates in private neurology practices: referral may be simpler than a computerized triage system.
abstract: OBJECTIVE
  The objective of this study is to compare a computerized deep brain stimulation (DBS) screening module (Comparing Private Practice vs. Academic Centers in Selection of DBS Candidates [COMPRESS], NeuroTrax Corp., Bellaire, TX, USA) with traditional triage by a movement disorders specialized neurologist as the gold standard.
  
  
  METHODS
  The COMPRESS consists of a combination of the Florida Surgical Questionnaire for Parkinson disease (FLASQ-PD), a cognitive assessment battery provided by MindStreams® (NeuroTrax Corp.), and the Geriatric Depression Scale and the Zung Anxiety Self-Assessment Scale. COMPRESS resulted in the classification of patients into three categories: "optimal candidate,""probable candidate," and "not a good candidate." Similar categorical ratings made by a referring private practice neurologist and by a trained movement disorders specialist were compared with the ratings generated by COMPRESS.
  
  
  RESULTS
  A total of 19 subjects with Parkinson's disease were enrolled from five private neurological practices. The clinical impressions of the private practice neurologist vs. those of the movement disorders specialist were in agreement approximately half the time (10/19 cases). The movement disorders specialist and COMPRESS agreed on 15/19 cases. A further comparison between outcomes from the entire COMPRESS module and the FLASQ-PD questionnaire by itself resulted in high agreement (18/19 cases in agreement).
  
  
  CONCLUSIONS
  The COMPRESS agreed with an in-person evaluation by a movement disorders neurologist approximately 80% of the time. The computerized COMPRESS did not provide any screening advantage over the short FLASQ-PD paper questionnaire. Larger studies will be needed to assess the utility and cost effectiveness of this computerized triage method for DBS.
authors.affiliation: Department of Neurology, University of Florida, Center for Movement Disorders and Neurorestoration, McKnight Brain Institute, Gainesville, FL 32610, USA.
authors.forename: Genko
authors.initials: G
authors.lastname: Oyama
authors.forename: Ramon L
authors.initials: RL
authors.lastname: Rodriguez
authors.forename: Jacob D
authors.initials: JD
authors.lastname: Jones
authors.forename: Camille
authors.initials: C
authors.lastname: Swartz
authors.forename: Stacy
authors.initials: S
authors.lastname: Merritt
authors.forename: Richard
authors.initials: R
authors.lastname: Unger
authors.forename: Monica
authors.initials: M
authors.lastname: Hubmann
authors.forename: Alain
authors.initials: A
authors.lastname: Delgado
authors.forename: Ely
authors.initials: E
authors.lastname: Simon
authors.forename: Glen M
authors.initials: GM
authors.lastname: Doniger
authors.forename: Dawn
authors.initials: D
authors.lastname: Bowers
authors.forename: Kelly D
authors.initials: KD
authors.lastname: Foote
authors.forename: Hubert H
authors.initials: HH
authors.lastname: Fernandez
authors.forename: Michael S
authors.initials: MS
authors.lastname: Okun
mesh_terms: D000368:Aged; D046690:Deep Brain Stimulation; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009462:Neurology / Q000379:methods; D010300:Parkinson Disease / Q000175:diagnosis / Q000628:therapy*; D018579:Patient Selection; D011331:Private Practice; D012017:Referral and Consultation; D014218:Triage / Q000379:methods*