A blinded, controlled trial of objective measurement in Parkinson’s disease
Holly Woodrow, Malcolm Horne, Chathurini V. Fernando, Katya Kotschet, Treat to Target Study Group, Arup Bhattacharya, Richard Blazé, Andrew Roy Charmley, Belinda Cruse, Stephen Duma, Andrew Evans, Mina Ghaly, Blake F. Giarola, Amy J. Halliday, Thomas Kimber, Anand Kumar, Alexander Lehn, Kate Lilley, Andrew Ma, Neil Mahant, Salar McModie, Manju Perera, Huiliang Melissa Tang, John W. Tillett, Stephen Tisch, Antony Winkel, Christine Wools
Abstract
Medical conditions with effective therapies are usually managed with objective measurement and therapeutic targets. Parkinson's disease has effective therapies, but continuous objective measurement has only recently become available. This blinded, controlled study examined whether management of Parkinson's disease was improved when clinical assessment and therapeutic decisions were aided by objective measurement. The primary endpoint was improvement in the Movement Disorder Society-United Parkinson's Disease Rating Scale's (MDS-UPDRS) Total Score. In one arm, objective measurement assisted doctors to alter therapy over successive visits until objective measurement scores were in target. Patients in the other arm were conventionally assessed and therapies were changed until judged optimal. There were 75 subjects in the objective measurement arm and 79 in the arm with conventional assessment and treatment. There were statistically significant improvements in the moderate clinically meaningful range in the MDS-UPDRS Total, III, IV scales in the arm using objective measurement, but not in the conventionally treated arm. These findings show that global motor and non-motor disability is improved when management of Parkinson's disease is assisted by objective measurement.