Predicting motor, cognitive and functional impairment in Parkinson’s

Objective We recently demonstrated that 998 features derived from a simple 7‐minute smartphone test could distinguish between controls, people with Parkinson's and people with idiopathic Rapid Eye Movement sleep behavior disorder, with mean sensitivity/specificity values of 84.6‐91.9%. Here, we investigate whether the same smartphone features can be used to predict future clinically relevant outcomes in early Parkinson's. Methods A total of 237 participants with Parkinson's (mean (SD) disease duration 3.5 (2.2) years) in the Oxford Discovery cohort performed smartphone tests in clinic and at home. Each test assessed voice, balance, gait, reaction time, dexterity, rest, and postural tremor. In addition, standard motor, cognitive and functional assessments and questionnaires were administered in clinic. Machine learning algorithms were trained to predict the onset of clinical outcomes provided at the next 18‐month follow‐up visit using baseline smartphone recordings alone. The accuracy of model predictions was assessed using 10‐fold and subject‐wise cross validation schemes. Results Baseline smartphone tests predicted the new onset of falls, freezing, postural instability, cognitive impairment, and functional impairment at 18 months. For all outcome predictions AUC values were greater than 0.90 for 10‐fold cross validation using all smartphone features. Using only the 30 most salient features, AUC values greater than 0.75 were obtained. Interpretation We demonstrate the ability to predict key future clinical outcomes using a simple smartphone test. This work has the potential to introduce individualized predictions to routine care, helping to target interventions to those most likely to benefit, with the aim of improving their outcome

Zur Entwicklung von Lebensstandard und Deprivation in Deutschland von 1996 bis 2003

Verschiedene Indikatoren deuten darauf hin, dass sich die deutsche Gesellschaft seit dem Ende der 90er Jahre stärker polarisiert hat. Die Arbeit fragt, ob sich ein zunehmender Teil der Bevölkerung Dinge des notwendigen Lebensstandards nicht mehr leisten kann. Anhand von fünf repräsentativen Bevölkerungsumfragen wird gezeigt, dass das Ausmaß der Deprivation seit Mitte der 90er Jahre mit der Höhe der Arbeitslosigkeit variiert und seit der Jahrtausendwende erheblich zugenommen hat. Abstract Several indicators show an increasing trend of polarization within the German society. This paper asks whether an increasing part of the German population is not able to afford the necessary standard of living in Germany. Using data from five representative surveys it is shown that the extent of deprivation varies with the amount of unemployment since the mid 90s and indeed has increased since 2000