title: Medical Record Review to Differentiate between Idiopathic Parkinson's Disease and Parkinsonism: A Danish Record Linkage Study with 10 Years of Follow-Up.
abstract: Background. The electronic medical records provide new and unprecedented opportunities for large population-based and clinical studies if valid and reliable diagnoses can be obtained, to determine what information is needed to distinguish idiopathic PD from Parkinsonism in electronic medical records. Methods. Chart review of complete medical records of 2,446 patients with a hospital discharge diagnosis of PD, who, between 1996 and 2009, were registered in the Danish National Hospital Register as idiopathic PD. All patients were examined in neurology departments. Clinical features were abstracted from charts to determine Parkinsonian phenotypes and disease course, using predefined criteria for idiopathic PD. Results. Chart review verified that 2,068 (84.5%) patients met criteria for idiopathic PD. The most distinguishing features of idiopathic PD patients were asymmetric onset, and fewer atypical features at onset or follow-up compared to Parkinsonism, and the area under the curve (AUC) for these items alone is moderate (0.74-0.77) and the highest AUC (0.91) was achieved when using all clinical features recorded in addition to PD medication use and a follow-up of 5 years or more. Conclusion. To reduce disease misclassification, information extracted from medical record review with at least 5 years of follow-up after first diagnosis was key to improve diagnostic accuracy.
authors.affiliation: Department of Neurology, Odense University Hospital, Odense, Denmark.
authors.forename: Lene
authors.initials: L
authors.lastname: Wermuth
authors.affiliation: Department of Epidemiology, University of California, Los Angeles, School of Public Health, Los Angeles, CA, USA.
authors.forename: Xin
authors.initials: X
authors.lastname: Cui
authors.affiliation: Department of Epidemiology, University of California, Los Angeles, School of Public Health, Los Angeles, CA, USA.
authors.forename: Naomi
authors.initials: N
authors.lastname: Greene
authors.affiliation: Channing Division of Network Medicine, Department of Medicine, Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA; Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria.
authors.forename: Eva
authors.initials: E
authors.lastname: Schernhammer
authors.affiliation: Department of Epidemiology, University of California, Los Angeles, School of Public Health, Los Angeles, CA, USA.
authors.forename: Beate
authors.initials: B
authors.lastname: Ritz