For a study, patients with severe Parkinson’s disease (PD) commonly endured debilitating motor problems. Deep brain stimulation (DBS), levodopa-carbidopa intestinal gel (LCIG), and continuous subcutaneous apomorphine infusion are all treatment possibilities (CSAI). Scientific data, professional knowledge, and patient preferences all played a role in deciding which therapies to use. To encourage patient participation in decision-making among possibilities, scientific evidence was tailored according to the information requirements. Researchers carried out a systematic review from the patient’s point of view.
To begin, patients chose the following outcomes for treatment: quality of life, activities of daily living, ON and OFF time, and adverse events. Second, they used the Grading of Recommendations, Assessment, Development, and Evaluation to perform a systematic review and meta-analysis of each therapy vs the best medical treatment (GRADE).
Finally, the evidence was turned into understandable and comparative data. Based on the smallest clinically meaningful difference and the cumulative distribution function, they transformed the meta-analysis results into the number of patients (per 100) who benefit clinically from an advanced treatment for each outcome. Although this method allows for a comparison of results across the three device-assisted regimens, no direct comparisons have been made. The very short follow-up duration in the included trials, generally less than 12 months, makes interpretation difficult. During the decision-making process, patients should be informed of these restrictions. The review assisted patients in integrating the data with their own preferences as well as their clinician’s knowledge in order to make an educated decision.
Reference:movementdisorders.onlinelibrary.wiley.com/doi/10.1002/
