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AANPAR10213a
Disclaimer
is pocket guide attempts to define principles of practice that should produce high-quality patient care.
It is applicable to specialists, primary care, and providers at all levels. is pocket guide should not
be considered exclusive of other methods of care reasonably directed at obtaining the same results. e
ultimate judgment concerning the propriety of any course of conduct must be made by the clinician
aer consideration of each individual patient situation. Neither IGC, the medical associations, nor the
authors endorse any product or service associated with the distributor of this clinical reference tool.
Abbreviations
AAN, American Academy of Neurolog y; CR, controlled-release; DA, dopamine agonist;
DAWS, dopamine agonist withdrawal syndrome; ICD, impulse control disorder; MAO-B,
monoamine oxidase type B; PD, Parkinson disease; QUIP, Questionnaire for Impulsive-
Compulsive Disorders in Parkinson Disease
Source
Pringsheim T et al. Practice guideline summary: Dopaminergic therapy for motor
symptoms in early Parkinson disease. Neurolog y. 2021 November 15. doi: 10.1212/
WNL.0000000000012868
Classification of Management Recommendations
Classification Definition
Level (A) Denotes a practice recommendation that must be done. In almost all
circumstances, adherence to the recommendation will improve health-
related outcomes. Almost all patients in this circumstance would desire
that the recommendation be followed.
Level (B) Corresponds to the helping verb should. Should recommendations tend
to be more common, as the requirements are less stringent but still based
on the evidence and benefit-risk profile.
Level (C) Corresponds to the helping verb may. May recommendations represent
the lowest allowable recommendation level the AAN considers useful
within the scope of clinical practice and can accommodate the highest
degree of practice variation.
Level (U) Indicates that the available evidence is insufficient to support or refute
the efficacy of an intervention.
Level (R) Assigned when the balance of benefits and harms is unknown and the
intervention is known to be exorbitantly expensive or have important
risks. is level designates that the intervention should not be used
outside of a research setting.
