title: Validity, sensitivity and specificity of the mentation, behavior and mood subscale of the UPDRS.
abstract: OBJECTIVE
  The unified Parkinson's disease rating scale (UPDRS) is the most widely used tool to rate the severity and the stage of Parkinson's disease (PD). However, the mentation, behavior and mood (MBM) subscale of the UPDRS has received little investigation regarding its validity and sensitivity. Three items of this subscale were compared to criterion tests to examine validity, sensitivity and specificity.
  
  
  METHODS
  Ninety-seven patients with idiopathic PD were assessed on the UPDRS. Scores on three items of the MBM subscale, intellectual impairment, thought disorder and depression, were compared to criterion tests, the telephone interview for cognition status (TICS), psychiatric assessment for psychosis and the geriatric depression scale (GDS). Non-parametric tests of association were performed to examine concurrent validity of the MBM items. The sensitivities, specificities and optimal cutoff scores for each MBM item were estimated by receiver operating characteristic (ROC) curve analysis.
  
  
  RESULTS
  The MBM items demonstrated low to moderate correlation with the criterion tests, and the sensitivity and specificity were not strong. Even using a score of 7.0 on the items of the MBM demonstrated a sensitivity/specificity of only 0.19/0.48 for intellectual impairment, 0.60/0.72 for thought disorder and 0.61/0.87 for depression. Using a more appropriate cutoff of 2.0 revealed sensitivities of 0.01, 0.38 and 0.13 respectively.
  
  
  CONCLUSIONS
  The MBM subscale items of intellectual impairment, thought disorder and depression are not appropriate for screening or diagnostic purposes. Tools such as the TICS and the GDS should be considered instead.
authors.affiliation: Department of Psychiatry and Neurobehavioral Sciences, University of Virginia Health System, Box 800623, Charlottesville, VA 22908, USA. sh4s@virginia.edu
authors.forename: Suzanne
authors.initials: S
authors.lastname: Holroyd
authors.forename: Lillian J
authors.initials: LJ
authors.lastname: Currie
authors.forename: G Frederick
authors.initials: GF
authors.lastname: Wooten
mesh_terms: D000368:Aged; D001519:Behavior / Q000502:physiology*; D003704:Dementia / Q000209:etiology; D003863:Depression / Q000175:diagnosis / Q000209:etiology; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007360:Intelligence; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000145:classification* / Q000175:diagnosis*; D010300:Parkinson Disease / Q000150:complications / Q000175:diagnosis / Q000523:psychology; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity