A Systematic Review of the Parkinson's Foundation Hospital Care Recommendations
Bibliographic record
Abstract
BACKGROUND: People with Parkinson's disease (PwP) face increased risks of complications and longer hospital stays compared to the general population. Four major factors contribute to increased morbidity and mortality during hospitalization: medication timing errors, administration of harmful medications, restricted mobility, and dysphagia. OBJECTIVES: To systematically review the literature on medication timing, contraindicated medications, mobility, and dysphagia in hospitalized PwP, and to evaluate the strength of evidence supporting the Parkinson's Foundation's consensus recommendations for inpatient care. METHODS: A systematic review was conducted by searching MEDLINE and EMBASE databases up to February 1, 2024. Original research articles involving hospitalized PwP were included. The level of evidence for each Parkinson's Foundation recommendations was assessed. RESULTS: The review included 33 studies. Multiple studies showed that medication errors were associated with longer hospital stays, motor deterioration, and increased mortality in PwP. Interventions such as electronic medical record alerts, staff education, and specialized PD units reduced medication errors. Limited evidence was found on the impact of immobility and dysphagia during hospitalization. CONCLUSIONS: The evidence base supporting the Parkinson's Foundation's hospital care recommendations varies in strength. Recommendations regarding medication timing and avoiding harmful medications are supported by multiple observational studies, while those for mobility and dysphagia are primarily based on expert opinion. Implementing these recommendations through multidisciplinary interventions may improve hospital care quality for PD. However, more high-quality research, including randomized controlled trials, is needed to evaluate intervention impacts and address identified knowledge gaps.
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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 | 0.026 | 0.113 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.008 | 0.008 |
| Bibliometrics | 0.019 | 0.013 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.004 | 0.003 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
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".