Movement Disorder Society‐sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS‐UPDRS): Process, format, and clinimetric testing plan

Movement Disorders - Tập 22 Số 1 - Trang 41-47 - 2007
Christopher G. Goetz1, Stanley Fahn2, Pablo Martínez‐Martín3, Werner Poewe4, Cristina Sampaio5, Glenn T. Stebbins1, Matthew B. Stern6, Barbara C. Tilley7, Richard Dodel8, Bruno Dubois9, Robert G. Holloway10, Joseph Jankovic11, Jaime Kulisevsky12, Anthony E. Lang13, Andrew J. Lees14, Sue E. Leurgans1, Peter A. LeWitt15, David L. Nyenhuis16, C. Warren Olanow17, Olivier Rascol18, Anette Schrag19, Jeanne A. Teresi20, Jacobus J. van Hilten21, Nancy R. LaPelle22
1Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
2Department of Neurology, Columbia University, New York, New York, USA
3Department of Neuroepidemiology, Carlos III Institute, Madrid, Spain
4Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
5Department of Pharmacology, Faculdade de Medicina de Lisboa, Lisboa, Portugal
6Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
7Biostatistics, Bioinformatics Epidemiology, Medical University of South Carolina, Charleston, South Carolina, USA
8Department of Neurology, Friedrich-Wilhelms-University, Bonn, Germany
9Department of Neurology, Hôpital de la Salpetriere, Paris, France
10Department of Neurology, University of Rochester, Rochester, New York, USA
11Department of Neurology, Baylor College of Medicine, Houston, Texas USA
12Department of Neurology, Sant Pau Hospital, Barcelona, Spain
13Division of Applied and Interventional Research, University of Toronto, Toronto, Canada
14Reta Lila Weston Institute of Neurological Studies, University College, London, England
15Department of Neurology, Wayne State University, Detroit, Michigan, USA
16Department of Neurology and Rehabilitation, University of Illinois, Chicago, Illinois, USA.
17Department of Neurology, Mount Sinai School of Medicine, New York, New York, USA
18Laboratoire de Pharmacologie Médicale et Clinique, Toulouse University, Toulouse, France
19Department of Clinical Neurosciences, University College, London, England
20Division of General Medicine, Columbia University, New York, New York, USA.
21Department of Neurology, Leiden University, Leiden, the Netherlands
22Division of Preventive and Behavioral Medicine, University of Massachusetts, Worcester, Massachusetts, USA.

Tóm tắt

AbstractThis article presents the revision process, major innovations, and clinimetric testing program for the Movement Disorder Society (MDS)–sponsored revision of the Unified Parkinson's Disease Rating Scale (UPDRS), known as the MDS‐UPDRS. The UPDRS is the most widely used scale for the clinical study of Parkinson's disease (PD). The MDS previously organized a critique of the UPDRS, which cited many strengths, but recommended revision of the scale to accommodate new advances and to resolve problematic areas. An MDS‐UPDRS committee prepared the revision using the recommendations of the published critique of the scale. Subcommittees developed new material that was reviewed by the entire committee. A 1‐day face‐to‐face committee meeting was organized to resolve areas of debate and to arrive at a working draft ready for clinimetric testing. The MDS‐UPDRS retains the UPDRS structure of four parts with a total summed score, but the parts have been modified to provide a section that integrates nonmotor elements of PD: I, Nonmotor Experiences of Daily Living; II, Motor Experiences of Daily Living; III, Motor Examination; and IV, Motor Complications. All items have five response options with uniform anchors of 0 = normal, 1 = slight, 2 = mild, 3 = moderate, and 4 = severe. Several questions in Part I and all of Part II are written as a patient/caregiver questionnaire, so that the total rater time should remain approximately 30 minutes. Detailed instructions for testing and data acquisition accompany the MDS‐UPDRS in order to increase uniform usage. Multiple language editions are planned. A three‐part clinimetric program will provide testing of reliability, validity, and responsiveness to interventions. Although the MDS‐UPDRS will not be published until it has successfully passed clinimetric testing, explanation of the process, key changes, and clinimetric programs allow clinicians and researchers to understand and participate in the revision process. © 2006 Movement Disorder Society

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