Final validation of an electronic diary for motor fluctuations and dyskinesias evaluation in Parkinson´s disease patients: Comparison with paper diary

CINTHIA TERROBA CHAMBI; ALEX MEDINA ESCOBAR; MALCO ROSSI; MARCELO MERELLO

Vancouver

Congreso; 21th International Congress of Parkinson?s Disease and Movement Disorders; 2017

Background: Despite ON-OFF paper diaries are widely used, adherence, duplication, fraudulent registry entries are frequent, data post processing and evaluation is time consuming and dyskinesias impact in life activities have not been assessed in an electronic device.Objective: To determine the reliability and compliance to an electronic motor diary in Parkinson's disease (PD) patients. Methods: We developed an electronic Android based open source touch screen application with medication alarms, adjustable intervals and medication dose settings to prevent retrospectively data entry to evaluate ON-OFF periods and dyskinesias. Validation of the electronic motor diary against medical examination was previously reported (1). A prospective second phase was completed with 16 consecutive patients that underwent a diary training session for a modified paper version of CAPSIT-PD and electronic diary support by the tablet. Participants were randomly assigned to start with one or other and they completed the diary during the same three consecutive days in two weeks. They selected, each 30 min periods, one of five possible states recommended for the registry of motor fluctuations by CAPSIT-PD. All diary set were included for the analysis, at paper diary individual time periods were excluded from analysis if there was no response (without data) or more than one response (mistake). The Unified Dyskinesias Rating Scale UDRS (historical section part 1: On-Dyskinesia and part 2 Off-Dystonia) was completed when each diary (paper or electronic) were finished.Results: Nine patients were male. The mean age and disease duration were 64.0±7.1 and 12.3±5.9 years respectively, mean education years was 12.5±3.5, mean MoCA was 25.2±2.4. The values of mean percentages and SD for the awake day and total sleep time for each diary categories for all patients over evaluation days were not different. There were no significant differences between paper and electronic diaries in OFF, partial OFF, ON, freezing dystonia times and number of falls. However differences were found for the categories dyskinesias time and sleep time [p=0.02 and p=0.04, respectively]. Conclusions: This electronic motor diary showed to be reliable for ON-OFF states and dyskinesias identification and classification according their impact on life?s activities. The logger showed no-inferiority when compared to the paper diary.