Minimal clinically important difference on the Motor Examination part of MDS-UPDRS.

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.

[1]  J. Jankovic,et al.  Movement Disorder Society‐sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS‐UPDRS): Scale presentation and clinimetric testing results , 2008, Movement disorders : official journal of the Movement Disorder Society.

[2]  Anette Schrag,et al.  Minimal clinically important change on the unified Parkinson's disease rating scale , 2006, Movement disorders : official journal of the Movement Disorder Society.

[3]  J. Janszky,et al.  [The impact of levodopa-carbidopa intestinal gel on health-related quality of life in Parkinson's disease]. , 2014, Ideggyogyaszati szemle.

[4]  G. Samsa,et al.  Determining Clinically Important Differences in Health Status Measures , 1999, PharmacoEconomics.

[5]  G. G. Stokes.  "J." , 1890, The New Yale Book of Quotations.

[6]  P. Klivényi,et al.  [VALIDATION OF THE HUNGARIAN MDS-UPDRS: WHY DO WE NEED A NEW PARKINSON SCALE?]. , 2014, Ideggyogyaszati szemle.

[7]  R. Hauser,et al.  Determination of minimal clinically important change in early and advanced Parkinson's disease , 2011, Movement disorders : official journal of the Movement Disorder Society.

[8]  A. Tóth,et al.  AZ MDS-UPDRS MAGYAR VALIDÁCIÓJA: MIÉRT SZÜKSÉGES ÚJABB PARKINSON-PONTOZÓSKÁLA? , 2014 .

[9]  J. Kállai,et al.  Sensitivity and specificity of Addenbrooke's Cognitive Examination, Mattis Dementia Rating Scale, Frontal Assessment Battery and Mini Mental State Examination for diagnosing dementia in Parkinson's disease. , 2012, Parkinsonism & related disorders.

[10]  P. Patil,et al.  Caregiver burden in patients with Parkinson disease undergoing deep brain stimulation: an exploratory analysis. , 2014, Journal of Parkinson's disease.

[11]  G. Stebbins,et al.  Vibration therapy for Parkinson's disease: Charcot's studies revisited. , 2012, Journal of Parkinson's disease.

[12]  S. Targum,et al.  The clinical global impressions scale: applying a research tool in clinical practice. , 2007, Psychiatry (Edgmont (Pa. : Township)).

[13]  W. Poewe,et al.  Minimal Clinically Important Difference in Parkinson's Disease as Assessed in Pivotal Trials of Pramipexole Extended Release , 2014, Parkinson's disease.

[14]  Ryan P. Duncan,et al.  Randomized Controlled Trial of Community-Based Dancing to Modify Disease Progression in Parkinson Disease , 2012, Neurorehabilitation and neural repair.

[15]  R. Hays,et al.  Recommended methods for determining responsiveness and minimally important differences for patient-reported outcomes. , 2008, Journal of clinical epidemiology.

[16]  G. Stebbins,et al.  Assessing the non‐motor symptoms of Parkinson's disease: MDS‐UPDRS and NMS Scale , 2015, European journal of neurology.

[17]  János Kállai,et al.  Neurokognitív zavarok diagnosztizálási és kezelési lehetőségei Parkinson-kórban , 2015 .

[18]  G. Guyatt,et al.  Measurement of health status. Ascertaining the minimal clinically important difference. , 1989, Controlled clinical trials.

[19]  J. Kállai,et al.  Screening Mild and Major Neurocognitive Disorders in Parkinson's Disease , 2015, Behavioural neurology.

[20]  P. Patil,et al.  The MDS-UPDRS tracks motor and non-motor improvement due to subthalamic nucleus deep brain stimulation in Parkinson disease. , 2013, Parkinsonism & related disorders.

[21]  Bente R Jensen,et al.  Improved clinical status, quality of life, and walking capacity in Parkinson's disease after body weight-supported high-intensity locomotor training. , 2013, Archives of physical medicine and rehabilitation.

[22]  T. Dóczi,et al.  Bilateral Subthalamic Stimulation can Improve Sleep Quality in Parkinson's Disease. , 2015, Journal of Parkinson's disease.

[23]  Jacob Cohen.  Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[24]  P. Buck,et al.  Scales for Assessing Nonmotor Symptom Severity Changes in Parkinson's Disease Patients With Symptom Fluctuations , 2010, The International journal of neuroscience.

[25]  Miss A.O. Penney.  (b) , 1974, The New Yale Book of Quotations.

[26]  Carmen Rodriguez-Blazquez,et al.  The MDS-UPDRS Part II (motor experiences of daily living) resulted useful for assessment of disability in Parkinson's disease. , 2013, Parkinsonism & related disorders.

[27]  W. Weiner,et al.  The clinically important difference on the unified Parkinson's disease rating scale. , 2010, Archives of neurology.

[28]  T. Foltynie,et al.  Motor and cognitive advantages persist 12 months after exenatide exposure in Parkinson's disease. , 2014, Journal of Parkinson's disease.

[29]  S. Fereshtehnejad,et al.  Tango for treatment of motor and non-motor manifestations in Parkinson's disease: a randomized control study. , 2015, Complementary therapies in medicine.

[30]  M. Gluck.  Cognitive Disorders in Parkinson's Disease , 2012 .

[31]  Anthony E. Lang,et al.  Movement Disorder Society Unified Parkinson Disease Rating Scale experiences in daily living: Longitudinal changes and correlation with other assessments , 2013, Movement disorders : official journal of the Movement Disorder Society.

[32]  M. Bergner.  Measurement of health status. , 1985, Medical care.

[33]  W. Poewe,et al.  Movement Disorder Society Task Force report on the Hoehn and Yahr staging scale: Status and recommendations The Movement Disorder Society Task Force on rating scales for Parkinson's disease , 2004, Movement disorders : official journal of the Movement Disorder Society.