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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]