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An early diagnosis is not the same as a timely diagnosis of Parkinson's disease.

Rees, RN; Acharya, AP; Schrag, A; Noyce, AJ; (2018) An early diagnosis is not the same as a timely diagnosis of Parkinson's disease. [Review]. F1000Res , 7 , Article 1106. 10.12688/f1000research.14528.1. Green open access

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Abstract

Parkinson's disease is a common neurodegenerative condition that has significant costs to the individual patient and to society. The pathology starts up to a decade before symptoms are severe enough to allow a diagnosis using current criteria. Although the search for disease-modifying treatment continues, it is vital to understand what the right time is for diagnosis. Diagnosis of Parkinson's disease is based on the classic clinical criteria, but the presence of other clinical features and disease biomarkers may allow earlier diagnosis, at least in a research setting. In this review, we identify the benefits of an early diagnosis, including before the classic clinical features occur. However, picking the right point for a "timely" diagnosis will vary depending on the preferences of the individual patient, efficacy (or existence) of disease-modifying treatment, and the ability for health systems to provide support and management for individuals at every stage of the disease. Good evidence for the quality-of-life benefits of existing symptomatic treatment supports the argument for earlier diagnosis at a time when symptoms are already present. This argument would be significantly bolstered by the development of disease-modifying treatments. Benefits of early diagnosis and treatment would affect not only the individual (and their families) but also the wider society and the research community. Ultimately, however, shared decision-making and the principles of autonomy, beneficence, and non-maleficence will need to be applied on an individual basis when considering a "timely" diagnosis.

Type: Article
Title: An early diagnosis is not the same as a timely diagnosis of Parkinson's disease.
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.12688/f1000research.14528.1
Publisher version: http://dx.doi.org/10.12688/f1000research.14528.1
Language: English
Additional information: Copyright: © 2018 Rees RN et al. This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Parkinson's disease, disease modifying therapy, ethics, neurodegeneration, personalized medicine, prodromal
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Movement Neurosciences
URI: http://discovery.ucl.ac.uk/id/eprint/10054472
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