Improving estimation of Parkinson’s disease risk—the enhanced PREDICT-PD algorithm
Abstract We previously reported a basic algorithm to identify the risk of Parkinson’s disease (PD) using published data on risk factors and prodromal features. Using this algorithm, the PREDICT-PD study identified individuals at increased risk of PD and used tapping speed, hyposmia and REM sleep beh...
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doaj-5c7b9a10084b4062b722e9cd999169632021-04-04T11:45:17ZengNature Publishing Groupnpj Parkinson's Disease2373-80572021-04-01711710.1038/s41531-021-00176-9Improving estimation of Parkinson’s disease risk—the enhanced PREDICT-PD algorithmJonathan P. Bestwick0Stephen D. Auger1Cristina Simonet2Richard N. Rees3Daniel Rack4Mark Jitlal5Gavin Giovannoni6Andrew J. Lees7Jack Cuzick8Anette E. Schrag9Alastair J. Noyce10Preventive Neurology Unit, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of LondonPreventive Neurology Unit, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of LondonPreventive Neurology Unit, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of LondonDepartment of Clinical and Movement Neuroscience, UCL Institute of Neurology, University College LondonBarts and The London School of Medicine and Dentistry, Queen Mary UniversityPreventive Neurology Unit, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of LondonPreventive Neurology Unit, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of LondonDepartment of Clinical and Movement Neuroscience, UCL Institute of Neurology, University College LondonPreventive Neurology Unit, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of LondonDepartment of Clinical and Movement Neuroscience, UCL Institute of Neurology, University College LondonPreventive Neurology Unit, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of LondonAbstract We previously reported a basic algorithm to identify the risk of Parkinson’s disease (PD) using published data on risk factors and prodromal features. Using this algorithm, the PREDICT-PD study identified individuals at increased risk of PD and used tapping speed, hyposmia and REM sleep behaviour disorder (RBD) as “intermediate” markers of prodromal PD in the absence of sufficient incident cases. We have now developed and tested an enhanced algorithm which incorporates the intermediate markers into the risk model. Risk estimates were compared using the enhanced and the basic algorithm in members of the PREDICT-PD pilot cohort. The enhanced PREDICT-PD algorithm yielded a much greater range of risk estimates than the basic algorithm (93–609-fold difference between the 10th and 90th centiles vs 10–13-fold respectively). There was a greater increase in the risk of PD with increasing risk scores for the enhanced algorithm than for the basic algorithm (hazard ratios per one standard deviation increase in log risk of 2.75 [95% CI 1.68–4.50; p < 0.001] versus 1.47 [95% CI 0.86–2.51; p = 0.16] respectively). Estimates from the enhanced algorithm also correlated more closely with subclinical striatal DaT-SPECT dopamine depletion (R 2 = 0.164, p = 0.005 vs R 2 = 0.043, p = 0.17). Incorporating the previous intermediate markers of prodromal PD and using likelihood ratios improved the accuracy of the PREDICT-PD prediction algorithm.https://doi.org/10.1038/s41531-021-00176-9 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jonathan P. Bestwick Stephen D. Auger Cristina Simonet Richard N. Rees Daniel Rack Mark Jitlal Gavin Giovannoni Andrew J. Lees Jack Cuzick Anette E. Schrag Alastair J. Noyce |
spellingShingle |
Jonathan P. Bestwick Stephen D. Auger Cristina Simonet Richard N. Rees Daniel Rack Mark Jitlal Gavin Giovannoni Andrew J. Lees Jack Cuzick Anette E. Schrag Alastair J. Noyce Improving estimation of Parkinson’s disease risk—the enhanced PREDICT-PD algorithm npj Parkinson's Disease |
author_facet |
Jonathan P. Bestwick Stephen D. Auger Cristina Simonet Richard N. Rees Daniel Rack Mark Jitlal Gavin Giovannoni Andrew J. Lees Jack Cuzick Anette E. Schrag Alastair J. Noyce |
author_sort |
Jonathan P. Bestwick |
title |
Improving estimation of Parkinson’s disease risk—the enhanced PREDICT-PD algorithm |
title_short |
Improving estimation of Parkinson’s disease risk—the enhanced PREDICT-PD algorithm |
title_full |
Improving estimation of Parkinson’s disease risk—the enhanced PREDICT-PD algorithm |
title_fullStr |
Improving estimation of Parkinson’s disease risk—the enhanced PREDICT-PD algorithm |
title_full_unstemmed |
Improving estimation of Parkinson’s disease risk—the enhanced PREDICT-PD algorithm |
title_sort |
improving estimation of parkinson’s disease risk—the enhanced predict-pd algorithm |
publisher |
Nature Publishing Group |
series |
npj Parkinson's Disease |
issn |
2373-8057 |
publishDate |
2021-04-01 |
description |
Abstract We previously reported a basic algorithm to identify the risk of Parkinson’s disease (PD) using published data on risk factors and prodromal features. Using this algorithm, the PREDICT-PD study identified individuals at increased risk of PD and used tapping speed, hyposmia and REM sleep behaviour disorder (RBD) as “intermediate” markers of prodromal PD in the absence of sufficient incident cases. We have now developed and tested an enhanced algorithm which incorporates the intermediate markers into the risk model. Risk estimates were compared using the enhanced and the basic algorithm in members of the PREDICT-PD pilot cohort. The enhanced PREDICT-PD algorithm yielded a much greater range of risk estimates than the basic algorithm (93–609-fold difference between the 10th and 90th centiles vs 10–13-fold respectively). There was a greater increase in the risk of PD with increasing risk scores for the enhanced algorithm than for the basic algorithm (hazard ratios per one standard deviation increase in log risk of 2.75 [95% CI 1.68–4.50; p < 0.001] versus 1.47 [95% CI 0.86–2.51; p = 0.16] respectively). Estimates from the enhanced algorithm also correlated more closely with subclinical striatal DaT-SPECT dopamine depletion (R 2 = 0.164, p = 0.005 vs R 2 = 0.043, p = 0.17). Incorporating the previous intermediate markers of prodromal PD and using likelihood ratios improved the accuracy of the PREDICT-PD prediction algorithm. |
url |
https://doi.org/10.1038/s41531-021-00176-9 |
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