Evaluation of Parkinson's Disease: A New Approach to Disability

Ginanneschi, A.; Degl'Innocenti, Francesco; Maurello, Maria Teresa; Magnolfi, Stefano; Marini, P.; Amaducci, L.

doi:10.1159/000110285

Cited by 15 publications

(7 citation statements)

References 6 publications

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“…Although interobserver agreement has been assessed for several PD clinical rating scales (27)(28)(29)(30)(31) and even for the UPDRS, studies have not examined physician-patient agreement in the historical section of the UPDRS. Kivela (24) compared health care professionals' with patients' assessments of disability in 205 elderly persons with chronic disease and found 84-97% concordance for assessments of dressing, eating, washing, and bathing.…”

Section: Discussionmentioning

confidence: 99%

Reliability of patient completion of the historical section of the unified Parkinson's disease rating scale

Louis¹,

Lynch²,

Marder

et al. 1996

Movement Disorders

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Evaluating the reliability of self-assessed disability in patients with Parkinson's disease (PD) is important for therapeutic trials epidemiologic surveys. This is the first study to examine the interrater reliability between physician and patient in the historical section of the Unified Parkinson's Disease Rating Scale (UPDRS). Thirty consecutive subjects with idiopathic PD self-administered the historical section of a modified UPDRS. This instrument was then readministered to these 30 subjects by a neurologist. Interobserver reliability was assessed with the weighted kappa statistic (kw). The kw for each of the 17 items in the historical section of the UPDRS ranged from 0.63 to 1.0 (moderate to excellent agreement). Total kw = 0.83 (95% confidence interval = 0.79-0.87). There were no correlations between kw and age, disease duration, dose of levodopa, Hoehn and Yahr score, Schwab and England score, or modified Mini-Mental State score. Nondemented subjects with PD may reliably assess their level of disability by self-administering the historical section of the UPDRS. This has important implications for the reliable use of self-administered disability instruments for clinical research.

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Section: Discussionmentioning

confidence: 99%

Reliability of patient completion of the historical section of the unified Parkinson's disease rating scale

Louis¹,

Lynch²,

Marder

et al. 1996

Movement Disorders

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“…19 Others have reported interrater reliability, as measured by k w , at 0.77. 35 There are no reports of the test-retest reliability or internal consistency of the NUDS.…”

Section: The Timed Up-and-go Test (Tug)mentioning

confidence: 99%

Psychometric Properties of Activity, Self-Efficacy, and Quality-of-Life Measures in Individuals with Parkinson Disease

Bello-Haas

Klassen²,

Sheppard³

et al. 2011

Physiotherapy Canada

134

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Purpose: To examine the psychometric properties of six outcome measures in people with Parkinson disease (PD). Method: Twenty-four participants completed the following twice within 2 weeks: the timed up-and-go test (TUG), Northwestern University Disability Scale (NUDS), Schwab & England ADL Scale (S&E), Activities-specific Balance Confidence (ABC) Scale, PD Questionnaire-Short Form (PDQ 8), and Stanford Self-Efficacy for Managing Chronic Disease 6-Item Scale (SSE). Internal consistency, test-retest reliability (ICC[3,1]), and minimal detectable change (MDC) scores were calculated. Convergent and discriminant validity of the ABC were examined. Results: Cronbach's alpha scores for the NUDS, ABC, PDQ-8, and SSE were 0.47, 0.92, 0.72, and 0.91 respectively. The intra-class correlation coefficient (ICC [3,1]) for the TUG was 0.69 and could be improved by averaging two trials. ICCs for the NUDS, S&E, ABC, PDQ-8, and SSE were 0.56, 0.70, 0.79, 0.82, and 0.72 respectively. The ABC correlated with the TUG (r ¼ À0.44, p ¼ 0.03) and with PDQ-8 (r s ¼ 0.51, p ¼ 0.01) and NUDS (r s ¼ 0.48, p ¼ 0.02) walking items. The ABC was able to discriminate between stages 1 and 3 of disease progression but not between stages 1 and 2, which suggests that the ABC can distinguish large differences in disease progression but cannot detect more subtle differences. Conclusions: Homogeneity of the ABC, PDQ-8, and SSE is good to excellent. Test-retest reliability scores of all measures except the NUDS are moderate to good. The ABC is a valid measure for use in PD. The MDC statistic may be useful for interpreting group score changes. 0,48, p ¼ 0,02). L'ABC a é té en mesure de sé parer les é tapes 1 et 3 de la progression de la maladie, mais n'a pu le faire entre les é tapes 1 et 2, ce qui porte à croire que l'ABC peut diffé rencier de plus grandes é tapes dans la progression de la maladie, mais ne peut dé tecter les diffé rences plus subtiles. Conclusions : L'homogé né ité de l'ABC, de la PDQ-8 et de la SSE varie de bonne à excellente. Les pointages au chapitre de la fiabilité test-retest de toutes les mesures, sauf celles de la NUDS, varient de modé ré s à bons. L'ABC constitue une mesure valide pour une utilisation pour la maladie de Parkinson. La statistique MDC peut ê tre utile pour l'interpré tation des changements dans les pointages du groupe.

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“…From a factor analysis, assessed in one study, three factors were derived, including (I) arm swing, gait, self‐care and posture; (II) speech and facies; (III) seborrhea 19. Four studies showed that the scale displays poor to moderate inter‐rater reliability 23–28…”

Section: Clinimetric Characteristics Of the Included Scalesmentioning

confidence: 99%

Systematic evaluation of rating scales for impairment and disability in Parkinson's disease

et al. 2002

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We assessed the clinometric characteristics of rating scales used for the evaluation of motor impairment and disability of patients with Parkinson's disease (PD), conducting a systematic review of PD rating scales published from 1960 to the present. Thirty studies describing clinometrics of 11 rating scales used for PD were identified. Outcome measures included validity (including factor structure), reliability (internal consistency, inter-rater, and intrarater) and responsiveness. We traced three impairment scales (Webster, Columbia University Rating Scale [CURS] and Parkinson's Disease Impairment Scale), four disability scales (Schwab and England, Northwestern University Disability Scale [NUDS], Intermediate Scale for Assessment of PD, and Extensive Disability Scale), and four scales evaluating both impairment and disability (New York University, University of California Los Angeles, Unified Parkinson's Disease Rating Scale [UPDRS], and Short Parkinson Evaluation Scale). The scales showed large differences in the extent of representation of items related to signs considered responsive to dopaminergic treatment or to those signs that appear late in the disease course and lack responsiveness to treatment. Regardless of the scale, there was a conspicuous lack of consistency concerning inter-rater reliability of bradykinesia, tremor, and rigidity. Overall disability items displayed moderate to good inter-rater reliability. The available evidence shows that CURS, NUDS, and UPDRS have moderate to good reliability and validity. In contrast to their widespread clinical use for assessment of impairment and disability in PD, the majority of the rating scales have either not been subjected to an extensive clinometric evaluation or have demonstrated clinometric shortcomings. The CURS, NUDS, and UPDRS are the most evaluated, valid, and reliable scales currently available.

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Evaluation of Parkinson's Disease: A New Approach to Disability

Cited by 15 publications

References 6 publications

Reliability of patient completion of the historical section of the unified Parkinson's disease rating scale

Reliability of patient completion of the historical section of the unified Parkinson's disease rating scale

Psychometric Properties of Activity, Self-Efficacy, and Quality-of-Life Measures in Individuals with Parkinson Disease

Systematic evaluation of rating scales for impairment and disability in Parkinson's disease

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