ArticleMovement disorders : official journal of the Movement Disorder Society2023
Using Movement Disorder Society Unified Parkinson's Disease Rating Scale Parts 2 and 3 Simultaneously: Combining the Patient Voice with Clinician Ratings.
Article in Movement disorders : official journal of the Movement Disorder Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Home physical therapy versus telerehabilitation in improving motor function and quality of life in Parkinson's disease: a randomized controlled trial.BMC geriatrics · 2024Trial
- Transforming Care Across Countries: Lessons from the Integrated Care Networks for Parkinson's Disease Study (iCARE-PD).Movement disorders : official journal of the Movement Disorder Society · 2026Observational
- Multimodal integration of serum DAPK1 and gastric myoelectrical activity reveals stage-specific correlates in Parkinson's disease.Frontiers in aging neuroscience · 2026Article
- Optimizing the MDS-UPDRS Part III for early-stage Parkinson's: early supportive evidence for a limb-related bradykinesia/rigidity sub-score.NPJ Parkinson's disease · 2025Article
- Deep Learning for Parkinson's Disease Diagnosis: A Graph Neural Network (GNN) Based Classification Approach with Graph Wavelet Transform (GWT) Using Protein-Peptide Datasets.Diagnostics (Basel, Switzerland) · 2024Article
- Sensor-Based Quantification of MDS-UPDRS III Subitems in Parkinson's Disease Using Machine Learning.Sensors (Basel, Switzerland) · 2024Article
- Co-Existent Probable RBD and PD: Disease Progression, Medication Response, and Clinical Trial Implications.Movement disorders clinical practice · 2024Article
- Association between GRIN2B polymorphism and Parkinson's disease risk, age at onset, and progression in Southern China.Frontiers in neurology · 2024Article
- Modeling of Parkinson's Disease Progression and Implications for Detection of Disease Modification in Treatment Trials.Journal of Parkinson's disease · 2024Article
- Summing MDS-UPDRS Parts 1 + 2 (Non-motor and Motor Experience of Daily Living): The Patient's Voice.Movement disorders : official journal of the Movement Disorder Society · 2023Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundRegulatory recommendations favor outcomes combining objective and patient input. The Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS), the most commonly used scale in Parkinson's disease (PD), includes patient and investigator ratings in distinct parts, but original clinimetric analyses failed to confirm the validity of combining parts by simple summing.
objectivesThe aim was to develop clinimetrically valid constructs for combining patient-reported Part 2 and investigator-rated Part 3 MDS-UPDRS scores.
methodsUsing 7888 MDS-UPDRS scores, we assessed construct validity of combined Part 2 and Part 3 items using exploratory factor analysis (EFA) and graded item response theory (IRT) with threshold criteria: comparative fit index ≥0.9 (EFA) and discrimination parameters ≥0.65 (IRT).
resultsThe direct sum of Parts 2 + 3 failed to meet the threshold for a valid outcome of PD severity (comparative fit index, CFI = 0.855). However, a two-domain construct combining item scores for tremor and non-tremor domains from Parts 2 and 3 confirmed validity, meeting both EFA and IRT criteria as distinct but correlated indices of disease severity (CFI = 0.923; discrimination mean 2.197 ± 0.480 [tremor] and 1.737 ± 0.344 [non-tremor] domains).
conclusionsThe sum of Parts 2 + 3 is not clinimetrically sound. However, considering tremor and non-tremor items of both Parts 2 and 3 as two outcomes results in a valid summary of PD motor severity that leverages simultaneous patient- and investigator-derived measures. This analytic application addresses regulatory prioritizations and retains the well-validated MDS-UPDRS items. In future interventional trials, we suggest that tremor and non-tremor components of PD motor severity from Parts 2 + 3 be monitored and analyzed to accurately detect objective changes that integrate the patient's voice. © 2023 International Parkinson and Movement Disorder Society.
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