title: Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): Process, format, and clinimetric testing plan.
abstract: 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 Although the MDS-UPDRS will not be published until it has successfully passed clinimetric testing, explanation of the process, key changes, and clinimetric programs allow clinicians and researchers to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.
authors.affiliation: Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois 60612, USA. cgoetz@rush.edu
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Goetz
authors.forename: Stanley
authors.initials: S
authors.lastname: Fahn
authors.forename: Pablo
authors.initials: P
authors.lastname: Martinez-Martin
authors.forename: Werner
authors.initials: W
authors.lastname: Poewe
authors.forename: Cristina
authors.initials: C
authors.lastname: Sampaio
authors.forename: Glenn T
authors.initials: GT
authors.lastname: Stebbins
authors.forename: Matthew B
authors.initials: MB
authors.lastname: Stern
authors.forename: Barbara C
authors.initials: BC
authors.lastname: Tilley
authors.forename: Richard
authors.initials: R
authors.lastname: Dodel
authors.forename: Bruno
authors.initials: B
authors.lastname: Dubois
authors.forename: Robert
authors.initials: R
authors.lastname: Holloway
authors.forename: Joseph
authors.initials: J
authors.lastname: Jankovic
authors.forename: Jaime
authors.initials: J
authors.lastname: Kulisevsky
authors.forename: Anthony E
authors.initials: AE
authors.lastname: Lang
authors.forename: Andrew
authors.initials: A
authors.lastname: Lees
authors.forename: Sue
authors.initials: S
authors.lastname: Leurgans
authors.forename: Peter A
authors.initials: PA
authors.lastname: LeWitt
authors.forename: David
authors.initials: D
authors.lastname: Nyenhuis
authors.forename: C Warren
authors.initials: CW
authors.lastname: Olanow
authors.forename: Olivier
authors.initials: O
authors.lastname: Rascol
authors.forename: Anette
authors.initials: A
authors.lastname: Schrag
authors.forename: Jeanne A
authors.initials: JA
authors.lastname: Teresi
authors.forename: Jacobus J
authors.initials: JJ
authors.lastname: Van Hilten
authors.forename: Nancy
authors.initials: N
authors.lastname: LaPelle
mesh_terms: 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