The comments are as follows... odds ratios (ORs) in this context are a little bit meaningless. How does one interpret an odds ratio of 160, let alone an OR of 1323 other than to say it looks like a lot?? By comparison, if you look at ORs between an established risk factor (such as smoking) and disease outcome (such as lung cancer), the ORs are between 20-40. It is not a criticism of the approach; in PREDICT-PD we too have traditionally modelled ORs. However, we rank an individual's OR against the ORs of everyone else in the cohort, meaning that, whilst not their literal risk, it is correct in relation to all other participants in the cohort.
The combination of the three factors has a positive predictive value of 35% - meaning that if you have all three together there is a 35% chance of you having a diagnosis of PD. Long story short... these three non-motor features, in combination, still look like some of the most useful for recognising PD... either in those that have a diagnosis or who are in the prodromal phase...
- Alastair Noyce
https://jnnp.bmj.com/content/early/2018/08/03/jnnp-2018-318275.long
The best part is that hyposmia is reversible with a mix of food additives and supplements, constipation is of course reversible and facial expression can be restored. If only someone was interested in following this up. Recent results indicate that even AD is reversible.
ReplyDeleteSo if research neurologists are convinced that a collection of non-motor symptoms are definitive for Parkinson's, WHY are they still going by the traditional motor-symptom scale for a diagnosis? It's VERY frustrating to have way more than 3 non-motor symptoms AND a family history AND one of the major genetic mutations AND other risk factors and still be told that multiple motor symptoms are required for a diagnosis. When are the criteria going to be changed?
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