Latencia diagnóstica en la enfermedad de Parkinson: Estudio en 200 pacientes de novo en un hospital público de Chile

Lay-Son, Luis; Eloiza, Claudio; Trujillo-Godoy, Osvaldo

doi:10.4067/s0034-98872015000700007

Cited by 6 publications

(13 citation statements)

References 8 publications

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“…None, however, are directly comparable due to differences in the precision and method of symptom onset definition, for example self-report versus first documentation in the medical record, or unclear definitions of symptom onset. In PD, the time to diagnosis is often rapid (9-15 months) [14][15][16], consistent with our study findings, though longer time intervals are reported [17][18][19]. Extending comparisons to other neurodegenerative diseases, the time intervals from symptom onset to diagnosis in PSP/CBD are also longer than those reported for MND [20][21][22][23][24][25][26][27][28][29], which range from 9.3 [20] to 16.2 months [29], and are most similar to diagnostic intervals reported in dementia, especially frontotemporal dementia [30][31][32][33].…”

Section: Discussionsupporting

confidence: 91%

The evolution of diagnosis from symptom onset to death in progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD) compared to Parkinson’s disease (PD)

Swallow

Counsell

2023

J Neurol

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Background Misdiagnosis and delayed diagnosis in progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD) are common. Few studies have systematically evaluated the diagnostic process from symptom onset to death in representative cohorts. Methods All PSP/CBD cases (n = 28/2) and age-sex matched Parkinson’s disease (PD) cases (n = 30) were identified from a UK prospective incident Parkinsonism cohort. Medical and research records were reviewed to compare median times from first index symptom to key diagnostic milestones and the nature/timing of secondary care referral and review. Results Index symptoms were similar apart from more tremor in PD (p < 0.001) and more impaired balance (p = 0.008) and falls (p = 0.004) in PSP/CBD. PD was diagnosed a median 0.96 years after index symptom. In PSP/CBD the median times from index symptom to identifying parkinsonism and then including PSP/CBD in the differential diagnosis and the final diagnosis were 1.88, 3.41 and 4.03 years, respectively (all p < 0.001). Survival from symptom onset in PSP/CBD and PD was not significantly different (5.98 vs 6.85 years, p = 0.72). More diagnoses (p < 0.001) were considered in PSP/CBD. Prior to diagnosis, PSP/CBD patients had more recurrent emergency attendances (33.3% vs 10.0%, p = 0.01) and were referred to more specialities than PD (median 5 vs 2). Time to any outpatient referral (0.70 vs 0.03 years, p = 0.025) and to specialist movement disorder review (1.96 vs 0.57 years, p = 0.002) was longer in PSP/CBD. Conclusions The duration and complexity of the diagnostic journey were greater in PSP/CBD than age-sex matched PD but can be improved. In this older cohort, there was little difference in survival from symptom onset in PSP/CBD and age-sex matched PD.

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Section: Discussionsupporting

confidence: 91%

The evolution of diagnosis from symptom onset to death in progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD) compared to Parkinson’s disease (PD)

Swallow

Counsell

2023

J Neurol

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“…This was the first report of the diagnosis latency in Chinese people with PD. Our results found that patients in China spent around 15 months from motor symptom onset to PD diagnose, which was much shorter than Chilean and Mexican reports [11, 12]. However, it was still longer than the diagnostic latency (12 months) in Britain [7].…”

Section: Discussionmentioning

confidence: 47%

“…A longer diagnostic latency always resulted in a more serious motor functional impairment. In our study, more than half of the newly diagnosed patients (68/131) were at H&Y grades of II and III, with a significant decline of the motor function and self-care abilities [11]. Our results indicated that proper strategies should be designed to reduce the diagnostic latency to ensure that Chinese people with PD could acquire the timely medical treatment, improving the quality of life.…”

Section: Discussionmentioning

confidence: 86%

Determinants of diagnostic latency in Chinese people with Parkinson’s disease

et al. 2019

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Background Clinical diagnosis of Parkinson’s disease (PD) has always lagged behind clinical symptoms. The diagnostic latency might be influenced by many factors. The diagnostic latency of Chinese people with PD has been unknown. Here we designed this cross-sectional study with the purpose to identify the diagnostic latency and its determinants in Chinese people with PD. Methods One hundred and thirty-one newly diagnosed people with PD were recruited into this study. Demographic and clinical characteristics as well as a detailed clinical history were collected. Motor and non-motor symptoms (NMSs) severity were assessed with appropriate assessment scales. Medical professional types in the first medical consultations were also recorded. According to the initially presenting motor phenotypes, patients would be divided into the groups of rest tremor, limb rigidity, movement slowness and walking problems. The investigated variables would be compared among the four groups. Results The PD diagnostic latency in China was around 15 months. It closely correlated to the severity of motor symptoms, anxiety and depression as well as the number of NMSs. The diagnostic latency significantly varied among the groups of different motor phenotypes of onset. Finally, initially presenting with limb rigidity, having more NMSs, motor symptoms at a more serious degree and the initial medical consultations with physicians or specialists of non-neurology were considered as determinants of a longer diagnostic latency of PD. Conclusions Patients presenting with minor motor symptoms and disturbing NMSs as well as physicians’ unfamiliarity with PD symptomology were determinants of the diagnostic delay of PD. Health education in community and improvement of the referral system might be proper strategies to shorten the diagnostic latency of PD.

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“…In our study, no difference in the time to seek medical care between motor subtypes was found. Finally, a longer time to diagnosis has been reported in PwP with EOPD ranging from 25 to 60 months [18][19][20] . Our study confirmed this finding.…”

Section: Discussionmentioning

confidence: 98%

Pitfalls and caveats in the diagnostic pathway of people with ParkinsonÓ?s disease

Cervantes-Arriaga¹,

Sarabia-Tapia²,

Esquivel-Zapata³

et al. 2022

RMN

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Objective:We carried out a cross-sectional study to identify the factors involved in each stage of the diagnosis pathway that may lead to a diagnostic delay in persons with Parkinson's disease (PD). Materials and Methods: Consecutive patients with PD were included. A questionnaire assessing the recognition of the initial symptoms, pathway to seek attention diagnosis and perception on the diagnostic time and identified barriers was applied. Diagnosis delay was defined as ≥ 12 months between initial recognition of the symptom and the definitive diagnosis of PD. Results: A total of 114 patients (57.9% male) with PD were included in the study. The overall median time of the diagnosis pathway was 14.5 (interquartile range [IQR] 31) months and the longest time in this pathway was between the first medical consultation and the definitive diagnosis of PD, a median of 9 (IQR 14) months. The main appraisal of the first symptom was being "not worried" (48.2%). The mains reasons for seeking medical attention were symptom worsening (42.1%). Patient's perception on the diagnostic time was reported as very adequate/adequate in 52.7%. Barriers delaying the diagnosis identified included the belief of spontaneous symptoms relief and lack of trust in their doctor. Conclusion: Both the person with PD and the physician play a shared role in the diagnosis of PD. Improving the awareness of the disease, as well as improving medical education on PD, could result in a timely diagnosis.

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Latencia diagnóstica en la enfermedad de Parkinson: Estudio en 200 pacientes de novo en un hospital público de Chile

Cited by 6 publications

References 8 publications

The evolution of diagnosis from symptom onset to death in progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD) compared to Parkinson’s disease (PD)

The evolution of diagnosis from symptom onset to death in progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD) compared to Parkinson’s disease (PD)

Determinants of diagnostic latency in Chinese people with Parkinson’s disease

Pitfalls and caveats in the diagnostic pathway of people with ParkinsonÓ?s disease

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