title: The Clinical Impression of Severity Index for Parkinson's Disease: international validation study.
abstract: This study sought to provide further information about the psychometric properties of the Clinical Impression of Severity Index for Parkinson's Disease (CISI-PD), in a large, international, cross-culturally diverse sample. Six hundred and fourteen patients with PD participated in the study. Apart from the CISI-PD, assessments were based on Hoehn & Yahr (HY) staging, the Scales for Outcomes in PD-Motor (SCOPA-M), -Cognition (SCOPA-COG) and -Psychosocial (SCOPA-PS), the Cumulative Illness Rating Scale-Geriatrics, and the Hospital Anxiety and Depression Scale. The total CISI-PD score displayed no floor or ceiling effects. Internal consistency was 0.81, the test-retest intraclass correlation coefficient was 0.84, and item homogeneity was 0.52. Exploratory and confirmatory factor analysis (CFI = 0.99, RMSEA = 0.07) confirmed CISI-PD's unifactorial structure. The CISI-PD showed adequate convergent validity with SCOPA-COG and SCOPA-M (r(S) = 0.46-0.85, respectively) and discriminative validity for HY stages and disease duration (P < 0.0001). In a multiple regression model, main CISI-PD predictors were SCOPA-M, disease duration, and depression. The results obtained were not only comparable to but also extended those yielded by the preliminary validation study, thus showing that the CISI-PD is a valid instrument to measure clinical impression of severity in PD. Its simplicity and easy application make it an attractive and useful tool for clinical practice and research.
authors.affiliation: National Centre for Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain. pmartinez@isciii.es
authors.forename: Pablo
authors.initials: P
authors.lastname: Martínez-Martín
authors.forename: Carmen
authors.initials: C
authors.lastname: Rodríguez-Blázquez
authors.forename: Maria João
authors.initials: MJ
authors.lastname: Forjaz
authors.forename: Jesús
authors.initials: J
authors.lastname: de Pedro
mesh_terms: D000368:Aged; D003071:Cognition; D003430:Cross-Sectional Studies; D003466:Cultural Characteristics; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009048:Motor Skills; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000145:classification*; D011594:Psychometrics; D012720:Severity of Illness Index; D012959:Socioeconomic Factors