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. 2024 Oct 16;21(10):1367. doi: 10.3390/ijerph21101367

Table 6.

Motivation for main inclusion or exclusion decisions—WHY1 and WHY2.

Why Decision Motivation
[WHY1]
Prodromal diagnosis 		SensH&F tests are administered to patients over 60 with hyposmia (reduced olfactory sensitivity).

  • Testing all people older than 60 or familiar with PD would have been practically and economically unfeasible.

  • Patients with hyposmia have an increased risk of developing PD [76,77].

  • SensH&F have already been proven to detect minor motor signs of PD in hyposmia patients [76,77].

  • Although patients with REM Sleep Behavior Disorder have an increased risk of developing PD, the complexity of diagnostic tools for this disorder does not make it suitable for screening [78,79].
Olfactory tests are administered by nurses at GP clinics Olfactory tests are cheap, fast, and easy to perform [80,81].
Nurses in territorial clinics administer SensH&F tests.

  • Creation and consolidation of territorial facilities to oversee local communities’ health [82].

  • Patients in the prodromal stage are usually autonomous.

  • Delegating SensH&F test administration to patients would involve providing SensH&F to and training a too vast number of patients.

  • GPs are bottleneck resources.

  • SensH&F test is simple

  • neurophysiopatology technicians are a very scarce resource working solely within the hospital’s premises

  • Paramedics are hardly qualified for the SensH&F test

  • Nurses are qualified for the SensH&F test

  • Assigning the SensH&F tests to nurses is consistent with the emergence of the family health nurse [82,83].
GP is the care coordinator of this macro-stage:

  • GP would prescribe an olfactory test to over 60 patients every two years.

  • GP would prescribe the SensH&F test to patients who test positive for the olfactory test.

  • GP would refer patients to a neurologist if the SensH&F test reveals suspicious values.

 The GP is the only one with the opportunity and information to play this role.
[WHY2]
Early diagnosis 		GPs would prescribe the SensH&F test to people complaining of motor symptoms. Patients typically go to the GP when they realize they have motor disorders.
Nurses in territorial clinics would administer SensH&F tests for patients with motor symptoms. All reasons given for prodromal diagnosis remain valid.