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Table 5 Agreement between physician’s judgment and Delphi criteria for APD (assessed on 60 APD patients)

From: Criteria for identification of advanced Parkinson’s disease: the results of the Italian subgroup of OBSERVE-PD observational study

APD Delphi criteria Patients with concordance with physician APD classification
N (%)
Cohen’s Kappa 95%—CI
Troublesome motor fluctuations, severity level (moderate or severe) 23 (38.3%) 0.415 0.284; 0.546
Off Time, hours/waking day (≥ 2) 18 (30%) 0.314 0.186; 0.443
Night-time sleep disturbances, severity level (moderate or severe) 23 (38.3%) 0.302 0.155;0.448
Troublesome dyskinesia, hours/waking day (≥ 2) 27 (45%) 0.469 0.335;0.603
Presence of non-motor fluctuations 36 (60%) 0.545 0.407; 0.683
Presence of “OFF” time at least every 3 h 16 (26.7%) 0.279 0.154; 0.404
Oral Levodopa dosing ≥ 5 times daily 34 (56.7%) 0.556 0.422; 0.690
Activities of daily living limitation, severity level (moderate or severe) 25 (41.7%) 0.421 0.284; 0.557
Falling frequency (most of the time or all the time) 7 (11.7%) 0.131 0.040; 0.222
Dementia, severity level (moderate or severe) 9 (15%) 0.125 0.015; 0.235
Psychosis, severity level (moderate or severe) 6 (10%) 0.084 -0.009; 0.177
Overall APD classification by Delphi method 56 (93.3%) 0.743 0.633; 0.853
  1. Levels of concordance by Cohen Kappa result interpreted as follows: values ≤ 0 as indicating no agreement; 0.1–0.20 as none to slight; 0.21–0.40 as fair, 0.41– 0.60 as moderate, 0.61–0.80 as substantial; 0.81–1.00 as almost perfect agreement [17]