Signs and Evidence

Making clinical sense of scientific data


Beware of the limitations of this tool

Parkinson disease

Calculated pretest probability: 1.07 %
Relevant inclusion criteria: Age > 60 


2Loss of balance

Clinical signs

3Glabella tap test
4Shuffling gait
5Walking heel-to-toe impaired

To further investigations

Sources used:

1.Rao G et al. Does this patient have Parkinson disease? JAMA. 2003 Jan 15;289(3):347-53
2.Gaenslen A et al. The specificity and sensitivity of transcranial ultrasound in the differential diagnosis of Parkinson's disease: a prospective blinded study. Lancet Volume 7, No. 5, p417–424, May 2008
3.Bouwmans AE et al. Specificity and sensitivity of transcranial sonography of the substantia nigra in the diagnosis of Parkinson's disease: prospective cohort study in 196 patients. BMJ Open. 2013 Apr 2;3(4)
4.Li DH et al. Diagnostic Accuracy of Transcranial Sonography of the Substantia Nigra in Parkinson’s disease: A Systematic Review and Meta-analysis. Scientific Reports volume 6, Article number: 20863 (2016)
5.Tysnes OB et al. Epidemiology of Parkinson's disease. J Neural Transm (Vienna). 2017 Aug;124(8):901-905
6.Pringsheim T et al. The prevalence of Parkinson's disease: A systematic review and meta‐analysis. Mov Disord. 2014; 29: 1583–1590