BackgroundThe diagnostic criteria for Parkinson's disease (PD) remain complex, which is especially problematic for nonmovement disorder experts. A test is required to establish a diagnosis of PD with improved accuracy and reproducibility.ObjectiveThe study aimed to investigate the sensitivity and specificity of tests using sniffer dogs to diagnose PD.MethodsA prospective, diagnostic case‐control study was conducted in four tertiary medical centers in China to evaluate the accuracy of sniffer dogs to distinguish between 109 clinically established medicated patients with PD, 654 subjects without PD, 37 drug‐naïve patients with PD, and 185 non‐PD controls. The primary outcomes were sensitivity and specificity of sniffer dog's identification.ResultsIn the study with patients who were medicated, when two or all three sniffer dogs yielded positive detection results in a sample tested, the index test sensitivity, specificity, and positive and negative likelihood ratios were 91% (95% CI: 84%–96%), 95% (95% CI: 93%–97%), and 19.16 (95% CI: 13.52–27.16) and 0.10 (95% CI: 0.05–0.17), respectively. The corresponding sensitivity, specificity, and positive and negative likelihood ratios in patients who were drug‐naïve were 89% (95% CI: 75%–96%), 86% (95% CI: 81%–91%), and 6.6 (95% CI: 4.51–9.66) and 0.13 (95% CI: 0.05–0.32), respectively.ConclusionsTests using sniffer dogs may be a useful, noninvasive, fast, and cost‐effective method to identify patients with PD in community screening and health prevention checkups as well as in neurological practice. © 2022 International Parkinson and Movement Disorder Society.

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Objectives: Plantar fasciitis (PF) is the most common cause of heel pain. Though PF is self-limited, it can develop into chronic pain and thus treatment is needed. Early and accurate prognostic assessment of patients with PF is critically important for selecting the optimal treatment pathway. Nevertheless, there is no scoring system to determine the severity of PF and no prognostic model in choosing between conservative or surgical treatment. The study aimed to develop a novel scoring system to evaluate the severity of plantar fasciitis and predict the prognosis of conservative treatment. Methods: Data of consecutive patients treated from 2014 to 2018 were retrospectively collected. One hundred and eighty patients were eligible for the study. The demographics and clinical characteristics served as independent variables. The least follow-up time was 6 months. A minimal reduction of 60% in the visual analog scale (VAS) score from baseline was considered as minimal clinically important difference (MCID). Those factors significantly associated with achieving MCID in univariate analyses were further analyzed by multivariate logistic regression. A novel scoring system was developed using the best available literature and expert-opinion consensus. Inter-observer reliability and intraobserver reproducibility were evaluated. The appropriate cutoff points for the novel score system were obtained using receiver operating characteristic (ROC) curves. Results: The system score = VAS (0-3 point = 1; 3.1-7 point = 3; 7.1-10 point = 5) + duration of symptoms (<6 months = 1; ≥1 6 months = 2) + ability to walk without pain (>1 h = 1; ≤1 h = 4) + heel spur in X-ray (No = 0; Yes = 2) + high intensity zone (HIZ) in MRI (No = 0; Yes = 2). The total score was divided in four categories of severity: mild (2-4 points), moderate (5-8 points), severe (9-12 points), and critical (13-15 points). Inter-observer agreement with a value of 0.84 was considered as perfect reliability. Intra-observer reproducibility with a value of 0.92 was considered as perfect reproducibility. The optimum cutoff value was 10 points. The sensitivity of predictive factors was 86.

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