Identifying Parkinson’s disease and parkinsonism cases using routinely-collected healthcare data: a systematic review

Harding, Zoe; Wilkinson, Tim; Stevenson, Anna J.; Horrocks, Sophie; Ly, Amanda; Schnier, Christian; Breen, David P.; Rannikmäe, Kristiina; Sudlow, Cathie; Uk, Dementias Platform

doi:10.1101/331652

Cited by 3 publications

(4 citation statements)

References 34 publications

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“…[38][39][40] Diagnosis of PD and its differential diagnostics is challenging, and false diagnoses are common in the early phase. 41,42 The proportion of excluded persons in FINPARK (25.9%) is in line with estimated proportion of misdiagnosed PD, [41][42][43][44] supporting the validity of outcome. It should be noted that the PD diagnoses were from nearly 20 consecutive years (1998-2015), and it is possible that there may have been variations in clinical diagnostic process.…”

Section: Discussionsupporting

confidence: 60%

Identification of Drugs Associated with Lower Risk of Parkinson’s Disease Using a Systematic Screening Approach in a Nationwide Nested Case–Control Study

Koponen¹,

Paakinaho²,

Lin³

et al. 2022

CLEP

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Introduction: Drugs for other indications may be repurposable as disease-modifying drugs for Parkinson's disease (PD). A systematic hypothesis-free approach can enable identification of candidates for repurposing. We applied a hypothesis-free systematic approach to identify drugs associated with lower risk of PD to discover candidates with potential for repurposing as disease-modifying drugs for PD and to illustrate challenges in observational studies that simultaneously investigate multiple repurposing candidates. Methods: The Finnish Parkinson's disease study (FINPARK), a nationwide nested case-control study, was randomized to screening (10,183 cases, 67,849 controls) and replication (10,184 cases, 67,754 controls) samples, including cases diagnosed in 1998-2015. After screening all univariable associations of register-derived exposure to individual-drug, group-and subgroup level since 1995 (exposure ≥3 years before outcome, threshold P = 0.1), different exposure periods were used in confounder-adjusted replication analyses. Results: In screening stage, the group-level (antipsoriatics and antigout preparations) and subgroup-level (cicatrizants, topical antipsoriatics, antigout preparations and mydriatics and cycloplegics) associations were mainly due to individual drugs. Seven other drugs (eg methotrexate, drugs for chronic obstructive pulmonary disease, COPD and/or asthma) were associated with lower risk. Associations of antigout preparations and antipsoriatics were replicated. COPD/asthma drugs, methotrexate and diabetes drugs were studied in separate, indication-restricted designs. Discussion: The results reflect the known risk factors and the implied role of the immune system in PD pathogenesis and spurious associations. They underline the importance of controlling for confounding by indication, which is challenging to apply to systematic screening.

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Section: Discussionsupporting

confidence: 60%

Identification of Drugs Associated with Lower Risk of Parkinson’s Disease Using a Systematic Screening Approach in a Nationwide Nested Case–Control Study

Koponen¹,

Paakinaho²,

Lin³

et al. 2022

CLEP

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“…In addition, in a recent systematic review that evaluated the accuracy of routinely collected health care data for identifying PD cases, the investigators found that the positive predictive value was >70% for a majority of hospital studies. 34 To our knowledge, this is the largest prospective study to investigate the association between alcohol intake and PD risk. The results suggest that alcohol intake does not materially influence the risk of PD in UK women.…”

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Alcohol Intake and Parkinson's Disease Risk in the Million Women Study

et al. 2019

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BACKGROUND Alcohol intake may be associated with a lower risk of Parkinson's disease (PD), but findings from previous studies have been inconclusive. OBJECTIVE To determine the association between alcohol intake and PD risk in the Million Women Study, a large, prospective study of women in the UK. METHODS Between 1996 and 2001, approximately 1.3 million women in the UK, mean age 56 (standard deviation, 5) years, were recruited into the Million Women Study. Information on alcohol intake, lifestyle factors, and medical history was collected at recruitment by questionnaire. Information on incident cases of PD was ascertained by record linkage to national hospital admission records and death registrations. We estimated multivariable‐adjusted relative risks and corresponding 95% confidence intervals using Cox proportional hazards models according to categories of alcohol intake. RESULTS During an average of 17.9 years of follow‐up, 11,009 women had a new record of PD among 1,309,267 women. In drinkers, the multivariable‐adjusted relative risk comparing women who drank more than 14 drinks of alcohol per week with women who drank 1 to 2 drinks of alcohol per week was 0.99 (95% confidence interval: 0.90, 1.10). Results did not materially change after excluding the first 10 years of follow‐up (relative riskadjusted = 1.01; 95% confidence interval: 0.90, 1.13). There were no significant trends in alcohol‐related PD risk among never smokers. Additionally, examining this association by type of alcohol intake also yielded null findings. CONCLUSION These results do not support an association between alcohol intake and PD risk in women. © 2019 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

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“…A third development relates to the rapidly increasing availability of large amounts of clinical data generated from electronic health records, registries, insurance claims, and even social media and wearable smart devices, and the ability to access, process, link, and analyze these data in fairly efficient ways, as compared to conducting RCTs (Jarrow, LaVange, and Woodcock, 2017). In medicine, many examples of such studies have been published across several domains and health problems, for instance, for estimating accuracy of diagnosis of: motor neuron disease (Horrocks et al, 2017); dementia (Wilkinson et al, 2018); and Parkinson's disease and parkinsonism (Harding et al, 2019); for prognosis of undiagnosed chest pain (Jordan et al, 2017); and to evaluate treatment on survival in metastatic melanoma (Van Zeijl et al, 2018). Routinely collected data are generated and collected during the course of health-care delivery, not primarily for research purposes, and therefore have the potential to minimize costs and effort and maximize representativeness and generalizability by capturing information in large populations over long periods from large databases that are continually updated as opposed to establishing treatment effectiveness using RCTs (Hemkens, Contopoulos-Ioannidis, and Ioannidis, 2016).…”

Section: Alternatives To Classic Randomized Controlled Trialsmentioning

confidence: 99%

Routinely collected data as real-world evidence for physiotherapy practice

Trijffel

Oostendorp

Elvers

2019

Physiotherapy Theory and Practice

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Evidence-based practice is the current undisputed predominant paradigm within medicine and allied health care, particularly in physiotherapy. Despite its potential benefits, over the years various points of criticism have been formulated one of which is the overreliance on randomized clinical trials as the highest level of evidence for treatment effectiveness. In the current era, where the availability of large amounts of clinical data gathered during the course of care delivery is rapidly increasing as well as our ability to access, process, link, and analyze these data in fairly efficient ways, alternative sources to supplement rather than replace evidence from RCTs look promising. In this Editorial, we discuss the opportunities and limitations of these routinely collected data in physiotherapy research and provide several examples from the literature. We conclude that the use of routinely collected data in physiotherapy research has the potential to increasingly contribute to real-world evidence, particularly in musculoskeletal primary care physiotherapy, provided that researchers are aware of methodological limitations and adhere to reporting standards.

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Identifying Parkinson’s disease and parkinsonism cases using routinely-collected healthcare data: a systematic review

Cited by 3 publications

References 34 publications

Identification of Drugs Associated with Lower Risk of Parkinson’s Disease Using a Systematic Screening Approach in a Nationwide Nested Case–Control Study

Identification of Drugs Associated with Lower Risk of Parkinson’s Disease Using a Systematic Screening Approach in a Nationwide Nested Case–Control Study

Alcohol Intake and Parkinson's Disease Risk in the Million Women Study

Routinely collected data as real-world evidence for physiotherapy practice

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