A novel 6-item screening questionnaire for Parkinsonism: validation and comparison between different instruments

Area of Science:

• Neurology
• Medical Diagnostics
• Epidemiology

Background:

• Existing Parkinson's disease (PD) screening tools lack consensus on optimal items and diagnostic accuracy.
• Development of a novel, highly valid screening questionnaire for parkinsonism is needed.

Purpose of the Study:

• To develop a new parkinsonism screening questionnaire by selecting the most valid items.
• To compare the diagnostic accuracy of the new instrument against existing screening tools.

Main Methods:

• A 25-item questionnaire was administered to 157 parkinsonism patients and 110 controls.
• Item selection was based on clinical utility index (CUI ≥0.64).
• Receiver operating characteristics (ROC) analysis compared diagnostic accuracy (Area Under Curve - AUC).

Main Results:

• Six items ('stiffness & rigidity', 'tremor & shaking', 'troublesome buttoning', 'troublesome arm swing', 'feet stuck to floor', 'slower daily activity') showed high clinical utility.
• The new six-item instrument achieved the highest AUC (0.977), indicating superior diagnostic value.

Conclusions:

• A novel six-item screening tool for parkinsonism demonstrates enhanced diagnostic accuracy.
• This validated instrument offers a valuable option for Parkinson's disease screening in population-based studies, particularly in resource-limited areas.