Anticipating Tomorrow: Tailoring Parkinson's Symptomatic Therapy Using Predictors of Outcome
Background Although research into Parkinson's disease (PD) subtypes and outcome predictions has continued to advance, recommendations for using outcome prediction to guide current treatment decisions remain sparse. Objectives To provide expert opinion‐based recommendations for individually tail...
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| Veröffentlicht in: | Movement disorders clinical practice (Hoboken, N.J.) Jg. 11; H. 8; S. 983 - 991 |
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| Sprache: | Englisch |
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Hoboken, USA
John Wiley & Sons, Inc
01.08.2024
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| Abstract | Background
Although research into Parkinson's disease (PD) subtypes and outcome predictions has continued to advance, recommendations for using outcome prediction to guide current treatment decisions remain sparse.
Objectives
To provide expert opinion‐based recommendations for individually tailored PD symptomatic treatment based on knowledge of risk prediction and subtypes.
Methods
Using a modified Delphi approach, members of the Movement Disorders Society (MDS) Task Force on PD subtypes generated a series of general recommendations around the question: “Using what you know about genetic/biological/clinical subtypes (or any individual‐level predictors of outcome), what advice would you give for selecting symptomatic treatments for an individual patient now, based on what their subtype or individual characteristics predict about their future disease course?” After four iterations and revisions, those recommendations with over 75% endorsement were adopted.
Results
A total of 19 recommendations were endorsed by a group of 13 panelists. The recommendations primarily centered around two themes: (1) incorporating future risk of cognitive impairment into current treatment plans; and (2) identifying future symptom clusters that might be forestalled with a single medication.
Conclusions
These recommendations provide clinicians with a framework for integrating future outcomes into patient‐specific treatment choices. They are not prescriptive guidelines, but adaptable suggestions, which should be tailored to each individual. They are to be considered as a first step of a process that will continue to evolve as additional stakeholders provide new insights and as new information becomes available. As individualized risk prediction advances, the path to better tailored treatment regimens will become clearer. |
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| AbstractList | Although research into Parkinson's disease (PD) subtypes and outcome predictions has continued to advance, recommendations for using outcome prediction to guide current treatment decisions remain sparse.
To provide expert opinion-based recommendations for individually tailored PD symptomatic treatment based on knowledge of risk prediction and subtypes.
Using a modified Delphi approach, members of the Movement Disorders Society (MDS) Task Force on PD subtypes generated a series of general recommendations around the question: "Using what you know about genetic/biological/clinical subtypes (or any individual-level predictors of outcome), what advice would you give for selecting symptomatic treatments for an individual patient now, based on what their subtype or individual characteristics predict about their future disease course?" After four iterations and revisions, those recommendations with over 75% endorsement were adopted.
A total of 19 recommendations were endorsed by a group of 13 panelists. The recommendations primarily centered around two themes: (1) incorporating future risk of cognitive impairment into current treatment plans; and (2) identifying future symptom clusters that might be forestalled with a single medication.
These recommendations provide clinicians with a framework for integrating future outcomes into patient-specific treatment choices. They are not prescriptive guidelines, but adaptable suggestions, which should be tailored to each individual. They are to be considered as a first step of a process that will continue to evolve as additional stakeholders provide new insights and as new information becomes available. As individualized risk prediction advances, the path to better tailored treatment regimens will become clearer. Although research into Parkinson's disease (PD) subtypes and outcome predictions has continued to advance, recommendations for using outcome prediction to guide current treatment decisions remain sparse.BACKGROUNDAlthough research into Parkinson's disease (PD) subtypes and outcome predictions has continued to advance, recommendations for using outcome prediction to guide current treatment decisions remain sparse.To provide expert opinion-based recommendations for individually tailored PD symptomatic treatment based on knowledge of risk prediction and subtypes.OBJECTIVESTo provide expert opinion-based recommendations for individually tailored PD symptomatic treatment based on knowledge of risk prediction and subtypes.Using a modified Delphi approach, members of the Movement Disorders Society (MDS) Task Force on PD subtypes generated a series of general recommendations around the question: "Using what you know about genetic/biological/clinical subtypes (or any individual-level predictors of outcome), what advice would you give for selecting symptomatic treatments for an individual patient now, based on what their subtype or individual characteristics predict about their future disease course?" After four iterations and revisions, those recommendations with over 75% endorsement were adopted.METHODSUsing a modified Delphi approach, members of the Movement Disorders Society (MDS) Task Force on PD subtypes generated a series of general recommendations around the question: "Using what you know about genetic/biological/clinical subtypes (or any individual-level predictors of outcome), what advice would you give for selecting symptomatic treatments for an individual patient now, based on what their subtype or individual characteristics predict about their future disease course?" After four iterations and revisions, those recommendations with over 75% endorsement were adopted.A total of 19 recommendations were endorsed by a group of 13 panelists. The recommendations primarily centered around two themes: (1) incorporating future risk of cognitive impairment into current treatment plans; and (2) identifying future symptom clusters that might be forestalled with a single medication.RESULTSA total of 19 recommendations were endorsed by a group of 13 panelists. The recommendations primarily centered around two themes: (1) incorporating future risk of cognitive impairment into current treatment plans; and (2) identifying future symptom clusters that might be forestalled with a single medication.These recommendations provide clinicians with a framework for integrating future outcomes into patient-specific treatment choices. They are not prescriptive guidelines, but adaptable suggestions, which should be tailored to each individual. They are to be considered as a first step of a process that will continue to evolve as additional stakeholders provide new insights and as new information becomes available. As individualized risk prediction advances, the path to better tailored treatment regimens will become clearer.CONCLUSIONSThese recommendations provide clinicians with a framework for integrating future outcomes into patient-specific treatment choices. They are not prescriptive guidelines, but adaptable suggestions, which should be tailored to each individual. They are to be considered as a first step of a process that will continue to evolve as additional stakeholders provide new insights and as new information becomes available. As individualized risk prediction advances, the path to better tailored treatment regimens will become clearer. Background Although research into Parkinson's disease (PD) subtypes and outcome predictions has continued to advance, recommendations for using outcome prediction to guide current treatment decisions remain sparse. Objectives To provide expert opinion‐based recommendations for individually tailored PD symptomatic treatment based on knowledge of risk prediction and subtypes. Methods Using a modified Delphi approach, members of the Movement Disorders Society (MDS) Task Force on PD subtypes generated a series of general recommendations around the question: “Using what you know about genetic/biological/clinical subtypes (or any individual‐level predictors of outcome), what advice would you give for selecting symptomatic treatments for an individual patient now, based on what their subtype or individual characteristics predict about their future disease course?” After four iterations and revisions, those recommendations with over 75% endorsement were adopted. Results A total of 19 recommendations were endorsed by a group of 13 panelists. The recommendations primarily centered around two themes: (1) incorporating future risk of cognitive impairment into current treatment plans; and (2) identifying future symptom clusters that might be forestalled with a single medication. Conclusions These recommendations provide clinicians with a framework for integrating future outcomes into patient‐specific treatment choices. They are not prescriptive guidelines, but adaptable suggestions, which should be tailored to each individual. They are to be considered as a first step of a process that will continue to evolve as additional stakeholders provide new insights and as new information becomes available. As individualized risk prediction advances, the path to better tailored treatment regimens will become clearer. |
| Author | Berg, Daniela Postuma, Ronald B. Rodríguez‐Violante, Mayela Bohnen, Nicolaas I. Erro, Roberto Dujardin, Kathy Mestre, Tiago A. Weintraub, Daniel Leentjens, Albert F.G. Simuni, Tanya Espay, Alberto J. Marras, Connie Hu, Michele T. |
| Author_xml | – sequence: 1 givenname: Ronald B. orcidid: 0000-0002-6468-4734 surname: Postuma fullname: Postuma, Ronald B. email: ron.postuma@mcgill.ca organization: Montreal Neurological Institute, McGill University – sequence: 2 givenname: Daniel surname: Weintraub fullname: Weintraub, Daniel organization: Philadelphia Veterans Affairs Medical Center – sequence: 3 givenname: Tanya surname: Simuni fullname: Simuni, Tanya organization: Northwestern University – sequence: 4 givenname: Mayela orcidid: 0000-0002-6041-9941 surname: Rodríguez‐Violante fullname: Rodríguez‐Violante, Mayela organization: National Institute of Neurology and Neurosurgery – sequence: 5 givenname: Albert F.G. orcidid: 0000-0002-7901-571X surname: Leentjens fullname: Leentjens, Albert F.G. organization: Maastricht University Medical Center – sequence: 6 givenname: Michele T. orcidid: 0000-0001-6382-5841 surname: Hu fullname: Hu, Michele T. organization: Oxford University and John Radcliffe Hospital – sequence: 7 givenname: Alberto J. orcidid: 0000-0002-3389-136X surname: Espay fullname: Espay, Alberto J. organization: University of Cincinnati – sequence: 8 givenname: Roberto orcidid: 0000-0002-7800-7419 surname: Erro fullname: Erro, Roberto organization: University of Salerno – sequence: 9 givenname: Kathy orcidid: 0000-0002-0110-574X surname: Dujardin fullname: Dujardin, Kathy organization: University of Lille, Inserm, Lille Neurosciences and Cognition, CHU‐Lille – sequence: 10 givenname: Nicolaas I. orcidid: 0000-0003-0352-6414 surname: Bohnen fullname: Bohnen, Nicolaas I. organization: University of Michigan, University of Michigan Udall Center, Ann Arbor VAMC – sequence: 11 givenname: Daniela surname: Berg fullname: Berg, Daniela organization: Christian‐Albrechts‐University – sequence: 12 givenname: Tiago A. orcidid: 0000-0002-6973-7479 surname: Mestre fullname: Mestre, Tiago A. organization: The Ottawa Hospital, The Ottawa Hospital Research Institute – sequence: 13 givenname: Connie surname: Marras fullname: Marras, Connie organization: Toronto Western Hospital, University Health Network |
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| Copyright | 2024 The Author(s). published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society. 2024 The Author(s). Movement Disorders Clinical Practice published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society. |
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| Issue | 8 |
| Keywords | prediction subtypes, therapy Parkinson's disease personalized medicine |
| Language | English |
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| Notes | Tiago A. Mestre and Connie Marras contributed equally to the manuscript. Relevant disclosures and conflict of interest are listed at the end of this article. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
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A community‐based study publication-title: Brain |
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Although research into Parkinson's disease (PD) subtypes and outcome predictions has continued to advance, recommendations for using outcome... Although research into Parkinson's disease (PD) subtypes and outcome predictions has continued to advance, recommendations for using outcome prediction to... |
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| StartPage | 983 |
| SubjectTerms | Delphi Technique Humans Parkinson Disease - drug therapy Parkinson Disease - therapy Parkinson's disease personalized medicine prediction subtypes, therapy Treatment Outcome |
| Title | Anticipating Tomorrow: Tailoring Parkinson's Symptomatic Therapy Using Predictors of Outcome |
| URI | https://onlinelibrary.wiley.com/doi/abs/10.1002%2Fmdc3.14089 https://www.ncbi.nlm.nih.gov/pubmed/38817000 https://www.proquest.com/docview/3063461480 |
| Volume | 11 |
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