Decision aid to support appropriate referral for Deep Brain Stimulation (DBS) in patients with Parkinson’s disease

A solution led by

Herman Stoevelaar Herman Stoevelaar


Many general neurologists feel insecure in identifying patients who could benefit from DBS. This may lead to both under- and over-referral of patients to a DBS reference centre.


Using the RAND/UCLA method, we developed a decision aid to help identify appropriate patients for DBS referral. It was Implemented and tested in real-life practice and a worldwide educational programme.

Implementation and evaluation 2005-2012

The Stimulus decision aid was used for educational meetings in various countries, followed by a monitoring study to assess its impact. For patients screened with Stimulus, the DBS acceptance rate was 77% versus 48% in the unscreened population. A recent study showed superiority of Stimulus over another tool.

Update 2013-2014

The results from new clinical studies and the demand for a decision aid deployable in advanced worldwide education warranted an update. We conducted a new panel study using the RAND/UCLA method, including 82 experts around the globe to create a new decision aid. The panel study was realised using our web-based rating suite.

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