title: Minimal clinically important difference on the Motor Examination part of MDS-UPDRS.
abstract: BACKGROUND
  Recent studies increasingly utilize the Movement Disorders Society Sponsored Unified Parkinson's Disease Rating Scale (MDS-UPDRS). However, the minimal clinically important difference (MCID) has not been fully established for MDS-UPDRS yet.
  
  
  OBJECTIVE
  To assess the MCID thresholds for MDS-UPDRS Motor Examination (Part III).
  
  
  METHODS
  728 paired investigations of 260 patients were included. At each visit both MDS-UPDRS and Clinician-reported Global Impression-Improvement (CGI-I) scales were assessed. MDS-UPDRS Motor Examination (ME) score changes associated with CGI-I score 4 (no change) were compared with MDS-UPDRS ME score changes associated with CGI-I score 3 (minimal improvement) and CGI-I score 5 (minimal worsening). Both anchor- and distribution-based techniques were utilized to determine the magnitude of MCID.
  
  
  RESULTS
  The MCID estimates for MDS-UPDRS ME were asymmetric: -3.25 points for detecting minimal, but clinically pertinent, improvement and 4.63 points for observing minimal, but clinically pertinent, worsening.
  
  
  CONCLUSIONS
  MCID is the smallest change of scores that are clinically meaningful to patients. These MCID estimates may allow the judgement of a numeric change in MDS-UPDRS ME on its clinical importance.
authors.affiliation: Doctoral School of Clinical Neuroscience, University of Pécs, Pécs, Hungary.
authors.forename: Krisztina
authors.initials: K
authors.lastname: Horváth
authors.affiliation: Doctoral School of Clinical Neuroscience, University of Pécs, Pécs, Hungary; Department of Neurology, University of Pécs, Pécs, Hungary.
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Aschermann
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary.
authors.forename: Péter
authors.initials: P
authors.lastname: Ács
authors.affiliation: Doctoral School of Clinical Neuroscience, University of Pécs, Pécs, Hungary; Department of Neurology, University of Pécs, Pécs, Hungary.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Deli
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary; MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary.
authors.forename: József
authors.initials: J
authors.lastname: Janszky
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary.
authors.forename: Sámuel
authors.initials: S
authors.lastname: Komoly
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary.
authors.forename: Éva
authors.initials: É
authors.lastname: Balázs
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary.
authors.forename: Katalin
authors.initials: K
authors.lastname: Takács
authors.affiliation: Institute of Behavioral Sciences, University of Pécs, Hungary.
authors.forename: Kázmér
authors.initials: K
authors.lastname: Karádi
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary; MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary. Electronic address: kovacsnorbert06@gmail.com.
authors.forename: Norbert
authors.initials: N
authors.lastname: Kovács
mesh_terms: D000368:Aged; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D010300:Parkinson Disease / Q000503:physiopathology*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D063189:Symptom Assessment; D016896:Treatment Outcome
keywords: Clinician reported outcome; Minimal clinically important change; Minimal clinically important difference; Receiver operating characteristic curve; UPDRS