Accuracy, Sensitivity, and Specificity of Different Tests to Detect Impaired Hand Function in Parkinsons disease

Abstract IntroductionParkinson’s Disease (PD) can affect hand function. To examine the diagnostic accuracy, sensitivity, and specificity of four traditionally used hand function tests in individuals with PD by using the receiver operator characteristic (ROC) analysis. MethodsEighty individuals (24 with PD and 56 healthy controls) performed the Jebsen-Taylor Hand Function Test (JTHF, with seven subtests), Nine-Hole Peg Test, and maximum power and pinch grip strength tests. The outcomes of the tests were compared between groups. The values of the area under the curve from the ROC analysis assessed the diagnostic accuracy, sensitivity, and specificity of the tests. ResultsIndividuals with PD presented worst performance than controls in all tests, except the writing subtest of the JTHF and maximum power strength. Two subtests of the JTHF, the turning cards and moving large, heavy objects, showed the highest area under the curve in the ROC analysis. The Nine- Hole Peg Test was able to distinguish the PD stage and progression, while the simulated feeding of the JTHFT subtest showed a high area under the curve only for PD stage analysis. ConclusionTwo dexterity tasks (turning cards and moving large, heavy objects) were highly discriminative of the hand function impairments in individuals with PD. The Nine-Hole Peg Test provides the most accurate identification of the PD stage and progression based on hand function impairment. Different dexterity tasks should be used depending on the aims of the evaluation, whether for diagnosis, monitoring, or classification of the PD.