TABLE 3.
Predictive values, sensitivity, and specificity of various case ascertainment variables (individually or in combination) and algorithms in identifying a working diagnosis of PD. Final column indicates degree of agreement with the gold standard (true positives plus true negatives). Expert chart review used as gold standard for all comparisons
| Sensitivity (95% CI) |
Specificity (95% CI) |
PPV (95% CI) |
NPV (95% CI) |
Agreed with chart review N (%) |
|
|---|---|---|---|---|---|
| Baseline inclusion criterion: | |||||
| In any clinic: 332.0 assigned ≥1 | 100% | 0.0% | 75.6% | Undefined | 436 (75.6%) |
| Codes assigned in any clinic: | |||||
| 332.0 assigned ≥ 2 | 89.2% (85.9–92.0) | 28.4% (21.1–36.6) | 79.4% (75.5–82.9) | 46.0% (35.2–57.0) | 429 (74.4%) |
| 332.0 assigned ≥ 5 | 67.0% (62.3–71.4) | 58.2% (49.6–66.4) | 83.2% (78.9–87.0) | 36.3% (30.0–42.9) | 374 (64.8%) |
| Codes assigned in any neurology clinic: | |||||
| 332.0 assigned ≥ 1 | 68.8% (64.2–73.1) | 43.3% (35.0–51.9) | 78.9% (74.5–82.9) | 31.0% (24.6–37.9) | 361 (62.6%) |
| 332.0 assigned ≥ 2 | 56.9% (52.1–61.6) | 71.6% (63.4–78.9) | 86.1% (81.6–89.9) | 34.9% (29.5–40.8) | 349 (60.5%) |
| 332.0 assigned ≥ 3 | 50.0% (45.2–54.8) | 78.0% (78.1–90.5) | 87.6% (86.9–94.5) | 33.5% (28.4–38.9) | 328 (56.8%) |
| Codes assigned in movement disorders specialty clinic: | |||||
| 332.0 assigned ≥ 1 | 33.0% (28.6–37.7) | 85.1% (78.1–90.5) | 87.3% (81.2–92.0) | 29.1% (24.8–33.8) | 264 (45.8%) |
| 332.0 assigned ≥ 2 | 28.4% (24.3–32.9) | 91.5% (85.6–95.5) | 91.2% (85.1–95.4) | 29.3% (25.0–33.7) | 253 (43.8%) |
| 332.0 assigned ≥ 3 | 25.5% (21.4–29.8) | 94.3% (89.1–97.5) | 93.3% (87.2–97.1) | 29.0% (24.9–33.4) | 244 (42.3%) |
| PD-related medicationa prescribed: | |||||
| Any of abovea | 80.0% (76.0–83.7) | 58.2% (49.6–66.4) | 85.5% (81.8–88.8) | 48.5% (40.8–56.3) | 431 (74.7%) |
| Algorithms: | |||||
| Unanimity algorithm | 78.0% (73.8–81.8) | 33.3% (25.6–41.8) | 78.3% (74.2–82.1) | 32.9% (25.3–41.2) | 387 (67.1%) |
| Unanimity algorithm with medications |
60.3% (55.6–64.9) | 74.5% (66.4–81.4) | 88.0% (83.7–91.4) | 37.8% (32.1–43.8) | 368 (63.8%) |
| Tiered consensus algorithm | 87.4% (83.9–90.4) | 45.4% (37.0–54.0) | 83.2% (79.4–86.5) | 53.8% (44.4–63.0) | 445 (77.1%) |
| Tiered consensus algorithm with medications |
77.1% (72.8–80.9) | 68.1% (59.7–75.7) | 88.2% (84.5–91.3) | 49.0% (41.8–56.2) | 432 (74.9%) |
a
Levodopa (in any formulation), pramipexole, ropinirole, pergolide, entacapone, or selegiline.