Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): Process, format, and clinimetric testing plan.
This 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 Although the MDS-UPDRS will not be published until it has successfully passed clinimetric testing, explanation of the process, key changes, and clinimetric programs allow clinicians and researchers to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.
Goetz
Christopher G
CG
Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois 60612, USA. cgoetz@rush.edu
Fahn
Stanley
S
Martinez-Martin
Pablo
P
Poewe
Werner
W
Sampaio
Cristina
C
Stebbins
Glenn T
GT
Stern
Matthew B
MB
Tilley
Barbara C
BC
Dodel
Richard
R
Dubois
Bruno
B
Holloway
Robert
R
Jankovic
Joseph
J
Kulisevsky
Jaime
J
Lang
Anthony E
AE
Lees
Andrew
A
Leurgans
Sue
S
LeWitt
Peter A
PA
Nyenhuis
David
D
Olanow
C Warren
CW
Rascol
Olivier
O
Schrag
Anette
A
Teresi
Jeanne A
JA
Van Hilten
Jacobus J
JJ
LaPelle
Nancy
N
D004185:Disability Evaluation; D006801:Humans; D009069:Movement Disorders / Q000175:diagnosis; D010300:Parkinson Disease / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D011594:Psychometrics; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires