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Recommendations were drafted based on relevant studies, systematic reviews, meta-analyses and high-quality guidelines identified by the literature search.
They were subsequently reviewed, revised, and voted by the Guideline Group in online consensus conferences. The guideline entails: i 10 PICOs and 23 recommendations on the diagnosis and treatment of urogenital, cardiovascular and gastrointestinal autonomic failure; ii four PICOs and four recommendations on the possible types of pain in PD individuals, their diagnosis and treatment; iii 11 PICOs and 11 recommendations on the screening, diagnosis and treatment of sleep disturbances and excessive daytime sleepiness in PD individuals, as well as on their prognostic implications.
Thirty-one out of 38 recommendations achieved a strong consensus. The current German PD guideline provides a practice-oriented and etiology-driven stepwise approach to the diagnosis and treatment of autonomic failure, pain and sleep disturbances in PD individuals.
The frequency and severity of PD non-motor symptoms however typically increases with disease duration, and has been associated with morbidity, mortality, more rapid disease progression and overall poorer quality of life of PD individuals and their caregivers [ 15 ].
