Remote levodopa challenge test in Parkinson's disease: Feasibility, reliability, validity and economic value

Author:

Zeng Zhitong1ORCID,Lin Zhengyu1ORCID,Chen Zhonglue2,Wan Xiaonan1,Zhou Haiyan3,Zhang Chencheng14ORCID,Sun Bomin1,Ren Kang2,Li Dianyou1

Affiliation:

1. Department of Neurosurgery, Centre for Functional Neurosurgery, Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai China

2. HUST‐GYENNO CNS Intelligent Digital Medicine Technology Centre Wuhan China

3. Department of Neurology and Institute of Neurology, Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai China

4. Clinical Neuroscience Centre, Ruijin Hospital LuWan Branch Shanghai Jiao Tong University School of Medicine Shanghai China

Abstract

AbstractBackground and purposeThe aim was to demonstrate the feasibility, reliability and validity of an in‐home remote levodopa challenge test (LCT), as delivered through an online platform, for patients with Parkinson's disease (PwPD).MethodsPatients with Parkinson's disease eligible for deep brain stimulation surgery screening were enrolled. Participants sequentially received an in‐home remote LCT and an in‐hospital standard LCT (separated by 2.71 weeks). A modified Movement Disorder Society Unified Parkinson's Disease Rating Scale Part III omitting rigidity and postural stability items was used in the remote LCT. The reliability of the remote LCT was evaluated using the intraclass correlation coefficient and the concurrent validity was evaluated using the Pearson's correlation coefficient r between the levodopa responsiveness of the remote and standard LCT.ResultsOut of 106 PwPD screened, 80 (75.5%) completed both the remote and standard LCT. There was a good reliability (intraclass correlation coefficient 0.81, 95% confidence interval 0.69–0.88) and a strong correlation (r = 0.84, 95% confidence interval 0.77–0.90) between the levodopa responsiveness of the remote and standard LCT. The mean cost for PwPD was estimated to be reduced by 91% by using the remote LCT.ConclusionThe remote LCT is feasible, reliable and valid and may reduce healthcare‐related costs for PwPD and their caregivers.

Funder

Shanghai Municipal Health Commission

Science and Technology Innovation Plan Of Shanghai Science and Technology Commission

Publisher

Wiley

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