Predictors of effective bilateral subthalamic nucleus stimulation for PD
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To the Editor:
Charles et al. make an important contribution with their article describing possible predictors of deep brain stimulation (DBS) of the subthalamic nucleus efficacy for PD.1 While DBS is highly effective and FDA approved, the procedure has considerable risks. Effective predictors could favorably shift the risk-to-benefit ratio. Unfortunately, the analysis performed is of limited value and potentially misleading.
A more appropriate analysis would be to report the area under the receiver–operator characteristic curve, which relates the specificity and sensitivity of the tests to age and levodopa responsiveness. The goal of any predictive task not only is to avoid surgery for those patients not likely to benefit but also to avoid withholding surgery from those that would. Visual inspection of the data …
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