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Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): Process, format, and clinimetric testing plan

  1. Christopher G. Goetz1,*,
  2. Stanley Fahn2,
  3. Pablo Martinez-Martin3,
  4. Werner Poewe4,
  5. Cristina Sampaio5,
  6. Glenn T. Stebbins1,
  7. Matthew B. Stern6,
  8. Barbara C. Tilley7,
  9. Richard Dodel8,
  10. Bruno Dubois9,
  11. Robert Holloway10,
  12. Joseph Jankovic11,
  13. Jaime Kulisevsky12,
  14. Anthony E. Lang13,
  15. Andrew Lees14,
  16. Sue Leurgans1,
  17. Peter A. LeWitt15,
  18. David Nyenhuis16,
  19. C. Warren Olanow17,
  20. Olivier Rascol18,
  21. Anette Schrag19,
  22. Jeanne A. Teresi20,
  23. Jacobus J. Van Hilten21,
  24. Nancy LaPelle22

Article first published online: 17 NOV 2006

DOI: 10.1002/mds.21198

Issue

Movement Disorders

Movement Disorders

Volume 22, Issue 1, pages 41–47, January 2007

Additional Information

How to Cite

Goetz, C. G., Fahn, S., Martinez-Martin, P., Poewe, W., Sampaio, C., Stebbins, G. T., Stern, M. B., Tilley, B. C., Dodel, R., Dubois, B., Holloway, R., Jankovic, J., Kulisevsky, J., Lang, A. E., Lees, A., Leurgans, S., LeWitt, P. A., Nyenhuis, D., Olanow, C. W., Rascol, O., Schrag, A., Teresi, J. A., Van Hilten, J. J. and LaPelle, N. (2007), Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): Process, format, and clinimetric testing plan. Movement Disorders, 22: 41–47. doi: 10.1002/mds.21198

Author Information

  1. 1

    Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA

  2. 2

    Department of Neurology, Columbia University, New York, New York, USA

  3. 3

    Department of Neuroepidemiology, Carlos III Institute, Madrid, Spain

  4. 4

    Department of Neurology, Innsbruck Medical University, Innsbruck, Austria

  5. 5

    Department of Pharmacology, Faculdade de Medicina de Lisboa, Lisboa, Portugal

  6. 6

    Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA

  7. 7

    Biostatistics, Bioinformatics Epidemiology, Medical University of South Carolina, Charleston, South Carolina, USA

  8. 8

    Department of Neurology, Friedrich-Wilhelms University, Bonn, Germany

  9. 9

    Department of Neurology, Hôpital de la Salpetriere, Paris, France

  10. 10

    Department of Neurology, University of Rochester, Rochester, New York, USA

  11. 11

    Department of Neurology, Baylor College of Medicine, Houston, Texas, USA

  12. 12

    Department of Neurology, Sant Pau Hospital, Barcelona, Spain

  13. 13

    Division of Applied and Interventional Research, University of Toronto, Toronto, Canada

  14. 14

    Reta Lila Weston Institute of Neurological Studies, University College, London, England

  15. 15

    Department of Neurology, Wayne State University, Detroit, Michigan, USA

  16. 16

    Department of Neurology and Rehabilitation, University of Illinois, Chicago, Illinois, USA

  17. 17

    Department of Neurology, Mount Sinai School of Medicine, New York, New York, USA

  18. 18

    Laboratoire de Pharmacologie Medicale et Clinique, Toulouse University, Toulouse, France

  19. 19

    Department of Clinical Neurosciences, University College, London, England

  20. 20

    Division of General Medicine, Columbia University, New York, New York, USA

  21. 21

    Department of Neurology, Leiden University, Leiden, The Netherlands

  22. 22

    Division of Preventive and Behavioral Medicine, University of Massachusetts, Worcester, Massachusetts, USA

*Department of Neurological Sciences, Rush University Medical Center, Suite 755, 1725 West Harrison Street, Chicago, IL 60612

Publication History

  1. Issue published online: 22 JAN 2007
  2. Article first published online: 17 NOV 2006
  3. Manuscript Revised: 14 JUL 2006
  4. Manuscript Accepted: 14 JUL 2006
  5. Manuscript Received: 17 MAY 2005

Funded by

  • Boehringer-Ingelheim USA
  • GlaxoSmithKline
  • Pfizer, Inc.

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Keywords:

  • Parkinson's disease;
  • rating scales;
  • Unified Parkinson's Disease Rating Scale;
  • clinimetrics

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. © 2006 Movement Disorder Society

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