Dr. Rodriguez-Oroz of the Clinica Universidad de Navarra, Pamplona, Spain, added that some limitations of the trial raise questions about the results. For example, neither patients nor evaluators were masked to treatment. Evaluations of dyskinesia and “off” period time could have been done with a more reliable tool than the complications of therapy subsection of the UPDRS. Investigators made their own judgment about whether a patient was in the “on” state (without assessment of inter-rater reliability). The DRS-II might be inadequate to assess cognitive ability in Parkinson's. And the investigators did not record nonserious adverse events.
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