{"id":21907,"date":"2025-05-29T11:00:34","date_gmt":"2025-05-29T15:00:34","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=21907"},"modified":"2025-06-05T11:10:25","modified_gmt":"2025-06-05T15:10:25","slug":"differences-in-parkinsons-disease-populations-teaching-hospitals-versus-other-settings-and-implications-for-clinical-trials","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/differences-in-parkinsons-disease-populations-teaching-hospitals-versus-other-settings-and-implications-for-clinical-trials\/","title":{"rendered":"Differences in Parkinson&rsquo;s Disease populations: teaching hospitals versus other settings and implications for clinical trials"},"content":{"rendered":"<p><strong>Background<\/strong> \u2014 Parkinson disease (PD) disease-modifying therapy (DMT) trials generally recruit individuals from teaching hospitals. Whether these participants represent the broader PD population is unclear.<\/p>\n<p><strong>Objective<\/strong> \u2014 The objective was to compare individuals with PD seen by neurologists in teaching hospitals early in their disease\u2014a proxy for DMT trial-eligible cohorts\u2014with individuals seen in other settings.<\/p>\n<p><strong>Methods<\/strong> \u2014 This retrospective cohort study using population-based data from Ontario (Canada) included individuals with PD from 1995 to 2017. Individuals with \u22651 PD visit with a teaching hospital neurologist within 3\u2009years served as a proxy for DMT trial-eligible participants. Comparators were individuals with PD seen in other settings. We compared age, sex, income, rurality, marginalization, and comorbidities. We measured time to milestones, including drug escalation, surgical\/infusion therapies, home care, dementia, long-term care admission, and death.<\/p>\n<p><strong>Results<\/strong> \u2014 We identified 19,948 individuals with PD, of whom 4386 (22.0%) were seen by a teaching hospital neurologist and 15,562 (78.0%) in other settings. Compared to other settings, individuals with teaching hospital neurology visits were younger, belonged to socioeconomically advantaged neighborhoods, and had fewer comorbidities. They had more drug escalation (unadjusted hazard ratio\u2009=\u20091.30; 95% confidence interval [CI]\u2009=\u2009(1.21, 1.38), surgical or infusion therapies (2.35 [2.09, 2.64]), and home care (1.06 [1.02, 1.10]). They had less dementia (0.813 [0.77, 0.86]), long-term care admission (0.62 [0.58, 0.67]), and death (0.68 [0.64, 0.72]).<\/p>\n<p><strong>Conclusions<\/strong> \u2014 Individuals with PD seen early by teaching hospital neurologists exhibited differences from the PD population. DMT trials in PD may exclude individuals with faster PD progression and from marginalized groups, impacting generalizability. Our study highlights health equity issues.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background \u2014 Parkinson disease (PD) disease-modifying therapy (DMT) trials generally recruit individuals from teaching hospitals. Whether these participants represent the broader PD population is unclear. Objective \u2014 The objective was to compare individuals with PD seen by neurologists in teaching hospitals early in their disease\u2014a proxy for DMT trial-eligible cohorts\u2014with individuals seen in other settings. [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[41,67,58],"migration-helper-qa-sample-set":[],"class_list":["post-21907","journal_article","type-journal_article","status-publish","hentry","topic-brain-diseases","topic-implementation-science-and-knowledge-translation","topic-research-and-methods"],"acf":{"citation":"Gros P, Marras C, Wang X, Chiu M, Farkouh ME, Emdin A, Bronskill SE. <em>Mov Disord<\/em>. 2025; May 29 [Epub ahead of print].","source_url":"https:\/\/doi.org\/10.1002\/mds.30239","ices_scientist":[1328,1159],"site":[6733],"research_program":[6740],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Differences in Parkinson&#039;s Disease populations: teaching hospitals versus other settings and implications for clinical trials<\/title>\n<meta name=\"description\" content=\"Background \u2014 Parkinson disease (PD) disease-modifying therapy (DMT) trials generally recruit individuals from teaching hospitals. Whether these\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/differences-in-parkinsons-disease-populations-teaching-hospitals-versus-other-settings-and-implications-for-clinical-trials\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ICES | Differences in Parkinson&#039;s Disease populations: teaching hospitals versus other settings and implications for clinical trials\" \/>\n<meta property=\"og:description\" content=\"Background \u2014 Parkinson disease (PD) disease-modifying therapy (DMT) trials generally recruit individuals from teaching hospitals. 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