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

• Published in: Parkinsonism & related disorders Vol. 21; no. 12; pp. 1421 - 1426
• Main Authors: Horváth, Krisztina, Aschermann, Zsuzsanna, Ács, Péter, Deli, Gabriella, Janszky, József, Komoly, Sámuel, Balázs, Éva, Takács, Katalin, Karádi, Kázmér, Kovács, Norbert
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-12-2015
• Subjects: Aged; Clinician reported outcome; Disease Progression; Female; Follow-Up Studies; Humans; Male; Middle Aged; Minimal clinically important change; Minimal clinically important difference; Motor Activity; Neurology; Parkinson Disease - physiopathology; Receiver operating characteristic curve; ROC Curve; Sensitivity and Specificity; Severity of Illness Index; Symptom Assessment; Treatment Outcome; UPDRS; Parkinson's disease; Clinician reported outcome; LR; interquartile range; MDS-UPDRS nM-EDL; Receiver operating characteristic curve; Motor Complications (Part IV of MDS-UPDRS); likelihood-ratio; MDS-UPDRS ME; PDSS-2; SD; MDS-UPDRS MC; MCID; clinically important difference; UPDRS; Motor Experiences of Daily Living (Part II of MDS-UPDRS); receiver operating characteristic; Minimal clinically important difference; CID; levodopa/carbidopa intestinal gel; HYS; Minimal clinically important change; MDS-UPDRS M-EDL; ROC; Levodopa equivalent dosage; LED; IQR; Non-motor Experiences of Daily Living (Part I of MDS-UPDRS); Movement Disorders Society Sponsored version of Unified Parkinson's Disease Rating Scale; Motor Examination (Part III of MDS-UPDRS); PD; Parkinson's Disease Sleep Scale 2nd version; LCIG; Hoehn-Yahr Stage; MDS-UPDRS; standard deviation
• ISSN: 1353-8020; 1873-5126
• DOI: 10.1016/j.parkreldis.2015.10.006

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.