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Validation of the “QUICK” questionnaire—A tool for diagnosis of “wearing-off” in patients with Parkinson's disease

Authors

  • Pablo Martinez-Martin MD, PhD,

    Corresponding author
    1. Neuroepidemiology Unit, National Centre for Epidemiology, Carlos III, Institute of Health, Madrid, Spain
    2. Centro de Investigación Biomédica en Red sobre Enfermedades, Neurodegenerativas (CIBERNED), Madrid, Spain
    • National Centre for Epidemiology, Carlos III Institute of Health, C/. Sinesio Delgado, 6, 28029 Madrid, Spain

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  • Eduardo Tolosa MD, PhD,

    1. Parkinson's Disease and Movement Disorders Unit, Neurology Service, Institut, Clínic de Neurociències, Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, Barcelona, Spain
    2. Centro de Investigación Biomédica en Red sobre Enfermedades, Neurodegenerativas (CIBERNED), Barcelona, Spain
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  • Basilio Hernandez MD,

    1. Medical Department, Novartis Farmaceutica, SA, Barcelona, Spain
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  • Xavier Badia MD, PhD,

    1. IMS Health, Barcelona, Spain
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  • ValidQUICK Study Group

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    • Members of the of the ValidQUICK Study Group are listed as an Appendix


Abstract

The main objective of the present study was to test the validity of a 19-items instrument (QUICK Questionnaire, QQ) as a tool for screening of WO. Two hundred twenty-two patients (36.0% without WO; 64.0% with mild or moderate/severe WO) were included. Diagnosis of WO by the participant neurologist was considered the “gold standard.” The complete Unified Parkinson's Disease Rating Scale battery, the Cumulative Illness Rating Scale-Geriatrics, and a form about WO presence and severity were completed by the neurologist. Patients independently completed the QQ just before the clinical assessment. As a whole, patients with WO were more disabled than patients without and patients with moderate/severe WO were in worse condition than patients with mild WO. The number of QQ symptoms declared to improve usually after the following dose of medication was 1.0 ± 1.8 in the group without WO, but 6.0 ± 3.8 in patients with WO (P < 0.001). A two QQ positive symptoms cut-off showed the following attributes: sensitivity, 88%; specificity, 80%; positive predictive value, 88.7%; negative predictive value, 79%; diagnostic accuracy, 85%; positive and negative likelihood ratios 4.4 and 0.15, respectively. The area under the ROC curve resulted 0.90 (CI95%: 0.86–0.94%). In summary, the QQ proved to be a valid screening tool to identify WO in PD patients. To our knowledge, the QQ is the only validated tool for diagnosis of WO. © 2008 Movement Disorder Society

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