The Modified Functional Status Questionnaire for Assessing Patients with Parkinson’s Disease Psychosis Treated with Pimavanserin: A Post Hoc Analysis
Bibliographic record
Abstract
Over half of patients with Parkinson’s disease experience psychosis (PDP) symptoms over the course of their disease. In addition to significantly impacting patients’ health-related quality of life and cognitive abilities, these symptoms impact patients’ activities of daily living (ADLs) and overall functional status. Clinical assessment of how psychosis impacts these measures is crucial; however, few studies have assessed functional status among patients with PDP. A previous phase 4 study assessing the impact of pimavanserin on ADLs in patients with PDP demonstrated that a modified version of the Functional Status Questionnaire (mFSQ) could be used for this purpose. This post hoc analysis aimed to demonstrate the utility of the mFSQ as a patient-reported outcomes tool and to expand on initial study findings by showing the impact of pimavanserin on ADLs and functional status for each mFSQ subscale. An analysis of mFSQ data was conducted on patients with PDP treated with pimavanserin. This analysis evaluated the least-squares mean (LSM) change from baseline to week 16 on the mFSQ by subscale (basic ADL, intermediate ADL, psychological function, quality of interaction, and social activity). Pearson’s correlation was used to assess the relationship between results from the mFSQ and the well-established Schwab and England ADL scale. In this assessment (n = 29), treatment with pimavanserin was associated with improvements on all 5 domains of the mFSQ, highlighting a broad improvement in ADLs and function. The greatest LSM (SE) improvement was seen in the social activity subscale [25.8 (7.52); 95% CI 10.2–41.5; p = 0.0026]. The mFSQ results demonstrated positive correlations with patient- and caregiver-rated Schwab and England ADL scales. This analysis provides additional information about the impact of treatment with pimavanserin on specific mFSQ subscales. Additionally, the mFSQ was significantly correlated with the patient- and the caregiver-rated Schwab and England ADL scales. Approximately half of all patients with Parkinson’s disease experience hallucinations or delusions. These are symptoms of a condition known as Parkinson’s disease psychosis (PDP). PDP impacts patients’ activities of daily living (ADLs) and functioning. Pimavanserin is an antipsychotic medication used to treat hallucinations and delusions associated with PDP. A previous study demonstrated that a newer, self-administered questionnaire called the modified Functional Status Questionnaire (mFSQ) can be used to evaluate ADLs and functioning in patients with PDP. The current analysis aims to understand the impacts of pimavanserin on ADLs and functioning, including physical health, psychological well-being, and social activity. We measured these using 5 parts (known as “subscales”) of the mFSQ. We used data from a previous study of 29 patients with PDP. Patients were treated with pimavanserin for 16 weeks. We measured changes in the 5 mFSQ subscales before and after treatment. We also measured how well the mFSQ results agreed with the results of another, well-established questionnaire (called the Schwab and England ADL scale) that also evaluates how well patients perform ADLs and was completed by the patients and caregivers. Treatment with pimavanserin was associated with improvements on all 5 subscales of the mFSQ. The greatest improvements were in the social activity subscale. We also found good agreement between the mFSQ and the well-established Schwab and England ADL scale, which supports the usefulness of the mFSQ in measuring ADLs and functioning in patients with PDP. This analysis is important because it provides additional information about the benefit of pimavanserin on ADLs and functioning.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".