Document Detail


The clinically important difference on the unified Parkinson's disease rating scale.
MedLine Citation:
PMID:  20065131     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the estimates of minimal, moderate, and large clinically important differences (CIDs) for the Unified Parkinson's Disease Rating Scale (UPDRS). DESIGN: Cross-sectional analysis of the CIDs for UPDRS total and motor scores was performed on patients with Parkinson disease (PD) using distribution- and anchor-based approaches based on the following 3 external standards: disability (10% on the Schwab and England Activities of Daily Living Scale), disease stage (1 stage on the Hoehn and Yahr Scale), and quality of life (1 SD on the 12-Item Short Form Health Survey). SETTING: University of Maryland Parkinson Disease and Movement Disorders Center, Patients Six hundred fifty-three patients with PD. RESULTS: A minimal CID was 2.3 to 2.7 points on the UPDRS motor score and 4.1 to 4.5 on the UPDRS total score. A moderate CID was 4.5 to 6.7 points on the UPDRS motor score and 8.5 to 10.3 on the UPDRS total score. A large CID was 10.7 to 10.8 points on the UPDRS motor score and 16.4 to 17.8 on the UPDRS total score. CONCLUSIONS: Concordance among multiple approaches of analysis based on subjective and objective data show that reasonable estimates for the CID on the UPDRS motor score are 2.5 points for minimal, 5.2 for moderate, and 10.8 for large CIDs. Estimates for the UPDRS total score are 4.3 points for minimal, 9.1 for moderate, and 17.1 for large CIDs. These estimates will assist in determining clinically meaningful changes in PD progression and response to therapeutic interventions.
Authors:
Lisa M Shulman; Ann L Gruber-Baldini; Karen E Anderson; Paul S Fishman; Stephen G Reich; William J Weiner
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of neurology     Volume:  67     ISSN:  1538-3687     ISO Abbreviation:  Arch. Neurol.     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-01-12     Completed Date:  2010-02-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372436     Medline TA:  Arch Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  64-70     Citation Subset:  AIM; IM    
Affiliation:
Departments of Neurology, University of Maryland Schoolof Medicine, Baltimore., MD 21201, USA. lshulman@som.umaryland.edu
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living / psychology
Adult
Aged
Aged, 80 and over
Cross-Sectional Studies
Data Collection
Data Interpretation, Statistical
Disability Evaluation*
Female
Humans
Hypokinesia / diagnosis,  physiopathology,  psychology
Male
Middle Aged
Muscle Rigidity / diagnosis,  physiopathology,  psychology
Neuropsychological Tests
Parkinson Disease / diagnosis*,  physiopathology,  psychology
Questionnaires
Severity of Illness Index*
Tremor / diagnosis,  physiopathology,  psychology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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