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[Limited value of the apomorphine test in Parkinson disease]
R A Roos1, T van Laar, J J van Hilten
1Academisch Ziekenhuis, afd. Neurologie, Leiden.
Objective:
To determine the predictive value of the subcutaneous apomorphine test for the effect of dopaminergic drugs in the treatment of Parkinson's disease.
Design:
Retrospective and literature study.
Setting:
University Hospital Leiden, the Netherlands.
Methods:
All articles regarding apomorphine administration in Parkinson's disease were reviewed. The data were compared with the results of apomorphine tests performed between October 1990 and September 1992 in the Leiden University Hospital.
Results:
The positive predictive value for good clinical efficacy of dopaminergic medication was 85%, lower than the results from the literature (96%). The negative predictive value was 58% (in the literature 75%), with a sensitivity of 73% and a specificity of 73%.
Conclusion:
These predictive values are poor and practical problems with the test are substantial. Little indication remains for the application of the apomorphine challenge test.