Biomedical subjects

H Andrews

Publications and source records attributed to H Andrews.

At least 19 recordsLinked to original sources

PubMed2003

Accuracy of family history data on Parkinson's disease.

BACKGROUND: Genetic studies of PD frequently rely on family history interviews (FHI), yet the accuracy of data obtained in this way is unclear. OBJECTIVE: To assess the interinformant reliability and validity of family history information on PD in first-degree relatives of PD cases and controls. METHODS: A structured FHI was administered to nondemented PD cases and controls and to a second informant (self-report, sibling or child of the subject) for each relative. Interinformant agreement was assessed on four algorithm-derived diagnostic categories of PD: definite, definite or probable, definite, probable or possible ("conservative diagnosis"); or definite, probable, possible, or uncertain ("liberal diagnosis"). The sensitivity and specificity of each diagnostic category were assessed, using as the gold standard diagnoses based on either in-person examination or medical record review. RESULTS: Five hundred thirty-six families containing 2,225 first-degree relatives were included in the interinformant reliability study. Agreement between informants was excellent for definite or probable PD for all three pairwise comparisons: proband vs self-report (kappa = 0.92), proband vs sibling of subject (kappa = 0.80), and proband vs child of subject (kappa = 0.87). Agreement was also good to excellent for the conservative diagnosis (kappa = 0.66, 0.49, and 0.79). In the validity analysis (141 individuals in 96 families), the conservative diagnosis provided the best combination of sensitivity (95.5%) and specificity (96.2%) for the proband's family history report. No difference was apparent across categories defined by case or control status, relationship to the proband, or gender or age at onset of the proband. However, specificity was lower for deceased relatives than for living relatives. CONCLUSION: The FHI can be used to obtain reliable and valid family history information on PD in first-degree relatives when a conservative diagnostic algorithm is applied.

Algorithms↗

PubMed2002

Primary care expenditures before the onset of Alzheimer's disease.

OBJECTIVE: To investigate primary care expenditures in the period before diagnosis of AD. METHODS: In a population-based sample of Medicare enrollees in New York City, person-level 1996 Medicare claims, summed over primary care encounters, were examined for people who developed AD in 1997 to 1998 and those who did not. RESULTS: People who developed AD were more likely to use Medicare outpatient and ambulatory care 1 to 2 years before diagnosis. Compared with respondents who did not develop AD, the excess cost for men was $1,167 (85% higher) and for women $239 (26% higher). Among elderly people > or = 75 years in the United States, the prodromal period of AD was associated with an excess Medicare-based primary care cost of $128.5 to $194.7 million. CONCLUSION: In addition to huge costs associated with AD after diagnosis, prediagnosis costs are an unrecognized source of expenditures related to the disease.

Black or African American↗

PubMed2002

Nitrous oxide (Entonox) inhalation and tolerance of transrectal ultrasound guided prostate biopsy: a double-blind randomized controlled study.

PURPOSE: We performed a randomized, placebo controlled double-blind trial to evaluate the effectiveness of Entonox (BOC Gases, Manchester, United Kingdom), that is 50% nitrous oxide and oxygen, as analgesia during transrectal ultrasound guided prostate biopsy. MATERIALS AND METHODS: Patients referred for transrectal ultrasound guided prostate biopsy for the first time as an outpatient procedure were recruited subject to exclusion criteria and randomized to breathe Entonox or air via similar breath activated devices. At the end of the procedure patients completed a visual pain analog scale. Patients who refused study participation also completed the visual analog pain scale to assess the placebo effect of receiving gas through a mask. RESULTS: A total of 110 patients were studied. Statistical analysis using 1-way analysis of variance showed a highly significant difference in pain perception among the 3 groups (F [2,107] = 73.348, p <0.001). This significant decrease in pain was noted in the Entonox versus air and Entonox versus placebo groups. There was no significant difference in the air and placebo groups. Seven of the 51 patients receiving Entonox complained of feeling drowsy during the procedure, which resolved at completion of the procedure. In this group 49 patients would undergo this procedure again if needed. In 2 of the 45 patients in the group receiving air the procedure was abandoned due to pain, while another 19 would prefer more analgesia and 2 would prefer general anesthesia if the procedure was to be repeated. CONCLUSIONS: Our study shows that Entonox is a safe, rapidly acting and effective form of analgesia for the pain of prostate biopsy. We believe that it should be the analgesia of choice for this procedure.

Aged↗

PubMed2001

BRCA1 and GADD45 mediated G2/M cell cycle arrest in response to antimicrotubule agents.

BRCA1 is a tumour suppressor gene implicated in the predisposition to early onset breast and ovarian cancer. We have generated cell lines with inducible expression of BRCA1 to evaluate its role in mediating the cellular response to various chemotherapeutic drugs commonly used in the treatment of breast and ovarian cancer. Induction of BRCA1 in the presence of Taxol and Vincristine resulted in a dramatic increase in cell death; an effect that was preceded by an acute arrest at the G2/M phase of the cell cycle and which correlated with BRCA1 mediated induction of GADD45. A proportion of the arrested cells were blocked in mitosis suggesting activation of both a G2 and a mitotic spindle checkpoint. In contrast, no specific interaction was observed between BRCA1 induction and treatment of cells with a range of DNA damaging agents including Cisplatin and Adriamycin. Inducible expression of GADD45 in the presence of Taxol induced both G2 and mitotic arrest in these cells consistent with a role for GADD45 in contributing to these effects. Our results support a role for both BRCA1 and GADD45 in selectively regulating a G2/M checkpoint in response to antimicrotubule agents and raise the possibility that their expression levels in cells may contribute to the toxicity observed with these compounds.

Antineoplastic Agents↗

PubMed2001

Incidence of AD in African-Americans, Caribbean Hispanics, and Caucasians in northern Manhattan.

OBJECTIVE: To compare the incidence rates for AD among elderly African-American, Caribbean Hispanic, and white individuals and to determine whether coincident cerebrovascular disease contributes to the inconsistency in reported differences among ethnic groups. METHODS: This was a population-based, longitudinal study over a 7-year period in the Washington Heights and Inwood communities of New York City. Annual incidence rates for AD were calculated and compared by ethnic group, and cumulative incidence adjusted for differences in education, diabetes, cardiovascular risk factors, and stroke was calculated. RESULTS: The age-specific incidence rate for probable and possible AD was 1.3% (95% CI, 0.8 to 1.7) per person-year between the ages of 65 and 74 years, 4.0% (95% CI, 3.2 to 4.8) per person-year between ages 75 and 84 years, and 7.9% (95% CI, 5.5 to 10.5) per person-year for ages 85 and older. Compared to white individuals, the cumulative incidence of AD to age 90 years was increased twofold among African-American and Caribbean Hispanic individuals. Adjustment for differences in number of years of education, illiteracy, or a history of stroke, hypertension, heart disease, or diabetes did not change the disproportionate risks among the three ethnic groups. CONCLUSION: The incidence rate for AD was significantly higher among African-American and Caribbean Hispanic elderly individuals compared white individuals. The presence of clinically apparent cardiovascular or cerebrovascular disease did not contribute to the increased risk of disease. Because the proportion of African-American and Caribbean Hispanic individuals reaching ages 65 and older in the United States is increasing more rapidly than the proportion of white individuals, it is imperative that this disparity in health among the elderly be understood.

Aged↗

PubMed2001

Uncovering BRCA1-regulated signalling pathways by microarray-based expression profiling.

The introduction of microarray technology to the scientific and medical communities has dramatically changed the way in which we now address basic biomedical questions. Expression profiling using microarrays facilitates an experimental approach where alterations in the transcript level of entire transcriptomes can be simultaneously assayed in response to defined stimuli. We have used microarray analysis to identify downstream transcriptional targets of the BRCA1 (Breast Cancer 1) tumour-suppressor gene as a means of defining its function. BRCA1 has been implicated in the predisposition to early onset breast and ovarian cancer and while its exact function remains to be defined, roles in DNA repair, cell-cycle control and transcriptional regulation have been implied. In the current study we have generated cell lines with tetracycline-regulated, inducible expression of BRCA1 as a tool to identify genes, which might represent important effectors of BRCA1 function. Oligonucleotide array-based expression profiling identified a number of genes that were upregulated at various times following inducible expression of BRCA1 including the DNA damage-responsive gene GADD45 (Growth Arrest after DNA Damage). Identified targets were confirmed by Northern blot analysis and their functional significance as BRCA1 targets examined.

BRCA1 Protein↗

PubMed2001

Outcome of fetal talipes following in utero sonographic diagnosis.

OBJECTIVES: To examine the association between fetal talipes and other defects, and outcome in relation to postnatal surgery. METHODS: All cases of talipes presenting to the fetal medicine unit between 1993 and 1998 and cases of isolated talipes presenting to the ultrasound department between 1991 and 1998 were examined. The infants were followed-up to determine the number of cases that had structural or positional talipes and the number of cases requiring surgery. RESULTS: There were 76 cases, 59 of which attended the fetal medicine unit and 17 the ultrasound department. Postnatal follow-up details were available in 31 of the 40 live births. There were three neonates with unilateral talipes at birth who were thought to have bilateral talipes on prenatal ultrasound and one neonate had bilateral talipes at birth who had been thought to have unilateral talipes prenatally. In two (6.4%) neonates in whom talipes was not confirmed at birth the abnormality was diagnosed prenatally. Of the 29 neonates with confirmed talipes at birth, the defect was structural in 26 (90%) cases and positional in three. Surgery was necessary in 21 (72%) of the 29 cases and 18 (86%) of those undergoing surgery required only one operation. When live births with associated anomalies were excluded, there were 24 cases with confirmed isolated talipes and 18 (75%) required surgery. CONCLUSIONS: This study provides long-term outcome data which can be used to complement current prenatal counseling and shows that in cases of fetal talipes diagnosed prenatally, 90% have a structural rather than a positional deformity. For isolated talipes three quarters of children will require surgery and in the majority of cases only one operation on the foot is necessary. Parents should be made aware of the small possibility of a false-positive diagnosis and discrepancy between the ultrasound and postnatal diagnoses of laterality.

Abnormalities, Multiple↗

PubMed2001

A model of therapeutic intervention with Indigenous Australians.

Many non-Aboriginal mental health practitioners are confronted by the lack of practical information pertaining to interventions with Aboriginal clientele. Subsequently, this may have engendered uncertainty in potential therapists and counsellors due to the lack of reliable, practical and culturally appropriate information. Those non-Aboriginal mental health practitioners working in the field with Aboriginal clients do so with varying degrees of success and build upon their knowledge base through personal experience and anecdotal information. Unfortunately, this information is often not made available to others working in the field through journal publication. This Practice Note examines a model of intervention aimed at developing relationships to enhance therapeutic interventions at the individual, family and systems level. As a way of clarification, the model is described via a case study involving a psychological intervention with a remote Aboriginal community.

Child, Preschool↗

PubMed2000

The effects of antipsychotic medication on saccadic eye movement abnormalities in Huntington's disease.

1. The study was a prospective open trial done to determine the effect of antipsychotic medication on saccadic eye movements in patients with Huntington's disease (HD). The authors tested 16 outpatients with HD, 8 of whom were drug free and 8 of whom were on antipsychotic medication. We also tested 24 healthy control subjects. 2. The antisaccade task was used to investigate the voluntary control of saccadic eye movements. Antisaccade latencies and error rates were used as outcome measures. Both HD patient groups showed significantly more antisaccade abnormalities than controls and the rate of abnormalities was very similar between the drug-free and medicated patient groups. 3. The results suggest that these abnormalities are related to underlying neuropathology rather than effects of medication. Either specific dysfunction of the dorsolateral prefrontal cortex or of the subcortical circuit connecting this cortical area to the superior colliculus via the striatum are likely to be responsible for the generation of such antisaccade eye movement abnormalities.

Adult↗

PubMed2000

Effects of clozapine and typical antipsychotic drugs on plasma 5-HT turnover and impulsivity in patients with schizophrenia: a cross-sectional study.

OBJECTIVE: To compare the efficacy of clozapine with typical antipsychotic drugs in controlling impulsivity and to explore the possible correlation of impulsivity with plasma 5-hydroxytryptamine (5-HT) levels, plasma 5-hydroxyindoleacetic acid (5-HIAA) levels and plasma 5-HT turnover. DESIGN: Prospective, cross-sectional study open to medication and blinded to biochemical analyses. PARTICIPANTS: Healthy control subjects (n = 24) and 46 inpatients and outpatients meeting the DSM-IV criteria for schizophrenia; 20 were being treated with clozapine and 26 were taking typical antipsychotic drugs. INTERVENTIONS: All psychotropic drugs other than clozapine or typical antipsychotic drugs were discontinued for at least 5 days and subjects fasted overnight before they were assessed. OUTCOME MEASURES: Coccaro Impulsivity Scale scores, plasma 5-HT levels, 5-HIAA levels and 5-HT turnover. RESULTS: Patients treated with clozapine and those treated with typical antipsychotics had significantly higher impulsivity scores than the control group, and the mean impulsivity score of the typical antipsychotic group was significantly higher than that of patients treated with clozapine. The mean concentration of 5-HT of the typical antipsychotic group was significantly lower than that of the control group and patients treated with clozapine; however, mean plasma levels of 5-HIAA were significantly higher for the clozapine group than the other 2 groups. 5-HT turnover was significantly higher for the 2 drug-treatment groups than for the control group. CONCLUSIONS: These results suggest that treatment with clozapine should be considered for patients with schizophrenia who are impulsive and aggressive.

Adult↗

PubMed1999

Validity of a performance-based test of function in essential tremor.

BACKGROUND: The central factor influencing therapeutic decisions in essential tremor (ET) is the functional impact of the tremor. Neither the neurological examination nor computerized tremor analysis measures function. Questionnaires may assess function, but data are highly subjective. Performance-based tests of functional impairment provide an alternative means with which to assess the functional impact of ET. OBJECTIVE: To determine the internal consistency and validity of a performance-based measure of functional impairment in ET. METHODS: Subjects with ET from a community in northern Manhattan, NY, and from a clinic and control subjects each underwent a 2 1/2-hour evaluation including 12 screening questions for ET, a 31-item Tremor Disability Questionnaire to assess the functional impact of tremor, a 26-item Videotaped Tremor Examination that was rated by a neurologist, a 15-item, 10-minute Performance-Based Test, and Quantitative Computerized Tremor Analysis. Internal consistency was assessed with Cronbach alpha. The correlation between the Performance-Based Test and these other measures of tremor was assessed by means of correlation coefficients (r). RESULTS: There were 50 ET cases and 51 normal control subjects. The Performance-Based Test was internally consistent (Cronbach alpha = .92). It also demonstrated validity among cases; the total score correlated with the total number of screening questions answered yes (r = 0.44; P = .001), the total score on the Tremor Disability Questionnaire (r=0.55; P<.001), the total score on the Videotaped Tremor Examination (r=0.71; P<.001), and multiple physiological measures recorded during Quantitative Computerized Tremor Analysis. CONCLUSIONS: A valid performance-based test was developed to objectively assess functional capacity in patients with ET. This test would be useful in therapeutic trials, where it would provide an objective means to quantify the functional impact of tremor.

Aged↗

PubMed1999

A comparison of different bedside tests for essential tremor.

OBJECTIVE: To compare the performance of different bedside tests for essential tremor (ET). BACKGROUND: Numerous tests (for example, writing, arm extension) may be used to elicit tremor in patients with ET. In large epidemiological surveys in which many patients must be evaluated efficiently, knowledge about the relative performance of these tests would be useful. METHODS: 154 subjects (42 with ET and 112 control subjects) were part of a community-based family study of ET in northern Manhattan, New York. Subjects underwent a tremor interview and a videotaped tremor examination which included six different tests for ET. Each of the six tests was performed with both the dominant and the nondominant arms. Two neurologists reviewed the videotaped examination and rated the severity of tremor during each test. Tremor ratings were 0 (none), +1 (mild), +2 (moderate), and +3 (severe). RESULTS: Among ET cases, there was considerable variation in the performance of each bedside test. With some tests (nondominant arm extension), as few as 48.8% of the ratings were >+2 and 29.8% of the ratings were 0 (no tremor). With other tests (finger-to-nose maneuver using nondominant arm), as many as 88.1% of the ratings were >+2 and only 2.4% were 0. Among the control subjects, there was also considerable variation in the performance of each test. Using some tests (finger-to-nose maneuver using nondominant arm), as many as 26.3% of the ratings were >+2, 72.8% were >+1 tremor, and only 27.2% of the ratings were 0. CONCLUSIONS: The performance of the tests varied considerably. In settings in which only one or two tests must be selected to screen a population, tests that are most likely to be abnormal in an ET case (finger-to-nose maneuver) could be used. In settings in which it is also desirable to exclude normal subjects, tests such as sustained arm extension, pouring water, or drawing a spiral could be used. Data regarding the performance of bedside tests for diagnosing ET are central to the design of research strategies for the clinical evaluation of patients with ET.

Aged↗

PubMed1999

Recent developments in the assessment of quality of life in multiple sclerosis (MS).

Multiple sclerosis (MS) and its treatment have broad-ranging effects on quality of life. This article reviews recent efforts to assess the impact of MS on activities of daily living (ADLs) and health-related quality of life (HRQL), and describes the development of the Multiple Sclerosis Quality of Life Inventory (MSQLI). The MSQLI is a modular MS-specific HRQL instrument consisting of a widely-used generic measure, the Health Status Questionnaire (SF-36), supplemented by nine symptom-specific measures (covering fatigue, pain, bladder function, bowel function, emotional status, perceived cognitive function, visual function, sexual satisfaction, and social relationships). Content validation consisted of evaluating its adherence to a conceptual model of the impact of MS, and review by MS specialists (neurologists and allied health professionals), HRQL experts, patients, and caregivers. The reliability and construct validity of the MSQLI were rigorously evaluated in a field test with 300 North American patients (198 female, 102 male) with definite MS (Poser criteria) and a broad range of physical impairment (EDSS=0. 0-8.5). This article concludes by comparing the MSQLI with two other MS-specific HRQL measures (MS Quality of Life-54 (QOL-54) and Functional Assessment of Multiple Sclerosis (FAMS)) and discussing key issues to consider in selecting an HRQL instrument for a collaborative database.

Activities of Daily Living↗

PubMed1999

The effects of clozapine on levels of total cholesterol and related lipids in serum of patients with schizophrenia: a prospective study.

OBJECTIVE: To investigate the effects of 12 weeks of clozapine treatment on levels of cholesterol and related lipids in patients with schizophrenia. DESIGN: Prospective study. SETTING: University department associated with a teaching hospital. PARTICIPANTS: Eight patients (6 women and 2 men) with a clinical diagnosis of schizophrenia consistent with DSM-IV criteria. The patients were classified as treatment-resistant and had not responded to treatment with at least 2 conventional antipsychotics. INTERVENTIONS: Current antipsychotic medications were tapered and treatment with clozapine was initiated. OUTCOME MEASURES: Cholesterol and serum lipid levels, as well as Brief Psychiatric Rating Scale (BPRS) scores were measured before and after 12 weeks of treatment with clozapine. RESULTS: Clozapine treatment significantly improved the BPRS scores but did not significantly alter serum lipid levels, except triglyceride levels, which increased. CONCLUSION: The previously reported lower levels of cholesterol in treatment-resistant patients with schizophrenia cannot be attributed to the effects of clozapine administration. Further research is required to support and clarify the effects of antipsychotic drugs on lipid levels.

Adult↗

PubMed1998

The APOE-epsilon4 allele and the risk of Alzheimer disease among African Americans, whites, and Hispanics.

CONTEXT: Although the association between Alzheimer disease (AD) and the apolipoprotein E epsilon4 (APOE-epsilon4) allele has been confirmed worldwide, it appears to be inconsistent among African Americans, Hispanics, and Nigerians. OBJECTIVE: To investigate the association between the APOE-epsilon4 allele and AD in elderly African Americans, Hispanics, and whites. DESIGN: Prospective, population-based, longitudinal study over a 5-year period (1991-1996). SETTING: The Washington Heights-Inwood community of New York City. PARTICIPANTS: A total of 1079 Medicare recipients without AD or a related disorder at baseline. MAIN OUTCOME MEASURES: Risk of clinically diagnosed AD in the 3 ethnic groups and among individuals with and without an APOE-epsilon4 allele. RESULTS: Compared with individuals with the APOE-epsilon3/epsilon3 genotype, the relative risk (RR) of AD associated with 1 or more copies of the APOE-epsilon4 allele was significantly increased among whites (RR, 2.5; 95% confidence interval [CI], 1.1-6.4), but not among African Americans (RR, 1.0; 95% CI, 0.6-1.6) or Hispanics (RR, 1.1; 95% CI, 0.7-1.6). In the absence of the APOE-epsilon4 allele, the cumulative risks of AD to age 90 years, adjusted for education and sex, were 4 times higher for African Americans (RR, 4.4; 95% CI, 2.3-8.6) and 2 times higher for Hispanics (RR, 2.3; 95% CI, 1.2-4.3) than for whites. In the presence of an APOE-epsilon4 allele, the cumulative risk of AD to age 90 years was similar for individuals in all 3 ethnic groups. CONCLUSION: The presence of an APOE-epsilon4 allele is a determinant of AD risk in whites, but African Americans and Hispanics have an increased frequency of AD regardless of their APOE genotype. These results suggest that other genes or risk factors may contribute to the increased risk of AD in African Americans and Hispanics.

Aged↗

PubMed1998

Contribution of smoking to excess mortality in Harlem.

The New York City neighborhood of Harlem has mortality rates that are among the highest in the United States. In absolute numbers, cardiovascular disease and cancer account for the overwhelming majority of deaths, especially among men, and these deaths occur at relatively young ages. The aim of this research was to examine self-reported smoking habits according to measures of socioeconomic status among Harlem men and women, in order to estimate the contribution of tobacco consumption to Harlem's remarkably high excess mortality. During 1992-1994, in-person interviews were conducted among 695 Harlem adults aged 18-65 years who were randomly selected from dwelling unit enumeration lists. The self-reported prevalence of current smoking was strikingly high among both men (48%) and women (41%), even among highly educated men (38%). The 21% of respondents without working telephones reported an even higher prevalence of current smoking (61%), indicating that national and state-based estimates which rely on telephone surveys may seriously underestimate the prevalence of smoking in poor urban communities. Among persons aged 35-64 years, the smoking attributable fractions for selected causes of death were larger in Harlem than in either New York City as a whole or the entire United States for both men and women. Tobacco consumption is likely to be one of several important mediators of the high numbers of premature deaths in Harlem.

Adolescent↗

PubMed1998

Diagnostic criteria for essential tremor: a population perspective.

BACKGROUND: Prevalence estimates vary 2750-fold among the 20 studies of essential tremor (ET). It is not clear how the choice of diagnostic criteria affects research results. OBJECTIVE: To determine the impact of alternative sets of diagnostic criteria on the diagnosis of ET. METHODS: As part of the Washington Heights-Inwood Genetic Study of ET (WHIGET), a population-based study of ET, 285 subjects who include 36 case subjects with probable or definite ET, 34 case subjects with possible ET, and 215 normal subjects were interviewed and examined. All diagnoses in WHIGET were assigned by 2 neurologists. Ten of the 20 published prevalence studies of ET provided diagnostic criteria for ET. Criteria differed in terms of requirements for the distribution, duration, and severity of tremor. These 10 sets of criteria were then each separately applied to the subjects in the WHIGET cohort to determine their impact on the diagnosis of ET. RESULTS: Depending on which diagnostic criteria were applied to the WHIGET cohort, the proportion of WHIGET case subjects with definite or probable ET who would have been diagnosed as having ET was as low as 14% and the proportion of WHIGET normal subjects who would have been diagnosed as having ET was as high as 51%. Diagnostic criteria that included a positive family history of ET or a lengthy duration of tremor would have classified many WHIGET case subjects with ET as normal, whereas criteria that did not specify a minimal tremor severity would have classified many WHIGET normal subjects as having ET. CONCLUSIONS: Alternative sets of diagnostic criteria for ET greatly impact on the diagnosis of ET. For population-based studies, information on tremor type and severity rather than family history should be included in diagnostic criteria.

Adolescent↗

PubMed1998

Does a screening questionnaire for essential tremor agree with the physician's examination?

In research studies of essential tremor (ET), monetary and geographic factors often necessitate diagnosis by interview rather than by examination. Few attempts have been made to determine the validity of a screening instrument for ET. A total of 242 subjects (33 definite or probable ET, 54 possible ET, and 155 normal) were part of a community-based family study of ET in northern Manhattan. Subjects underwent a tremor interview and videotaped tremor examination. The interview included 12 screening questions for ET. Two neurologists rated the severity of tremor on videotape and assigned diagnoses. The subjects' responses to the 12 screening questions were compared with the neurologic examination and the neurologists' diagnoses. There was an association between the number of affirmative responses on the 12-item screen and the severity of tremor during the videotaped tremor examination (r = 0.66, p < 0.01). Including those with probable and definite ET and defining a positive screen result as an affirmative response to at least 1 of 12 screening questions, the sensitivity of the screening questionnaire was 73%, the specificity was 96%, and the positive predictive value was 80%. The responses to the questionnaire closely correlated with the severity of tremor on neurologic examination. The questionnaire had moderate validity for subjects with probable or definite ET; subjects with mild ET often screened negative. Hence, in population-based studies and family studies of ET, it is important to examine all subjects for the presence of mild asymptomatic ET.

Adolescent↗