caa a22 4500 445809442 CHVBK 20180317145207.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1007/s00415-010-5814-y doi (NATIONALLICENCE)springer-10.1007/s00415-010-5814-y A tool to improve pre-selection for deep brain stimulation in patients with Parkinson's disease [Elektronische Daten] [Tobias Wächter, Adolfo Mínguez-Castellanos, Francesc Valldeoriola, Jan Herzog, Herman Stoevelaar] Determining the eligibility of patients with Parkinson's disease (PD) for deep brain stimulation (DBS) can be challenging for general (non-specialised) neurologists. We evaluated the use of an online screening tool (Stimulus) that aims to support appropriate referral to a specialised centre for the further evaluation of DBS. Implementation of the tool took place via an ongoing European multicentre educational programme, currently completed in 15 DBS centres with 208 referring neurologists. Use of the tool in daily practice was monitored via an online data capture programme. Selection decisions of patients referred with the assistance of the Stimulus tool were compared to those of patients outside the screening programme. Three years after the start of the programme, 3,128 patient profiles had been entered. The intention for referral was made for 802 patients and referral intentions were largely in accordance with the tool recommendations. Follow-up at 6months showed that actual referral took place in only 28%, predominantly due to patients' reluctance to undergo brain surgery. In patients screened with the tool and referred to a DBS centre, the acceptance rate was 77%, significantly higher than that of the unscreened population (48%). The tool showed a sensitivity of 99% and a specificity of 12% with a positive and negative predictive value of 79 and 75%, respectively. The Stimulus tool is useful in assisting general neurologists to identify appropriate candidates for DBS consideration. The principal reason for not referring potentially eligible patients is their reluctance to undergo brain surgery. The Author(s), 2010 Parkinson's disease nationallicence Deep brain stimulation nationallicence Appropriateness method nationallicence Decision support nationallicence Wächter Tobias Centre of Neurology and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Syler-Str. 3, 72076, Tübingen, Germany aut Mínguez-Castellanos Adolfo Department of Neurology, University Hospital Virgen de las Nieves, Granada, Spain aut Valldeoriola Francesc Hospital Clinic, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain aut Herzog Jan Department of Neurology, Christian Albrechts University, Kiel, Germany aut Stoevelaar Herman Centre for Decision Analysis and Support, Ismar Healthcare, Lier, Belgium aut Journal of Neurology Springer-Verlag 258/4(2011-04-01), 641-646 0340-5354 258:4<641 2011 258 415 https://doi.org/10.1007/s00415-010-5814-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00415-010-5814-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Wächter Tobias Centre of Neurology and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Syler-Str. 3, 72076, Tübingen, Germany aut NATIONALLICENCE 700 1- Mínguez-Castellanos Adolfo Department of Neurology, University Hospital Virgen de las Nieves, Granada, Spain aut NATIONALLICENCE 700 1- Valldeoriola Francesc Hospital Clinic, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain aut NATIONALLICENCE 700 1- Herzog Jan Department of Neurology, Christian Albrechts University, Kiel, Germany aut NATIONALLICENCE 700 1- Stoevelaar Herman Centre for Decision Analysis and Support, Ismar Healthcare, Lier, Belgium aut NATIONALLICENCE 773 0- Journal of Neurology Springer-Verlag 258/4(2011-04-01), 641-646 0340-5354 258:4<641 2011 258 415 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer