Evaluation of Parkinson’s Disease: Reliability of Three Rating Scales

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

doi:10.1159/000110159

Cited by 41 publications

(25 citation statements)

References 6 publications

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“…Our k values for HY and CURS were higher than in our previous study concerning the agreement of rating scales [7], carried out by using non-weighted k but the kw method cannot be employed when there are 3 or more examiners. If we analyze the present data by means of the non-weighted k, we notice no more difference and results over lap.…”

Section: Discussioncontrasting

confidence: 80%

“…Other scales, such as Activity of Daily Living Index [6], are sporadically used. We studied the reli ability of this type of scale because in a pre vious survey [7] we assumed that disability scales measured more constant variables than clinical rating scales. The NUDS was used by us as it is widely employed in clinical studies, but we noticed that this instrument evaluated the complex handicaps of PD pa tients only in a partial way.…”

Section: Introductionmentioning

confidence: 99%

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

Ginanneschi

Degl'Innocenti²,

Maurello³

et al. 1991

Neuroepidemiology

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Testing the reliability and usefulness of disability scales in Parkinson''s disease has been the object of a study carried out by 4 neurologists on 48 patients using 2 rating scales – Hoehn and Yahr staging and Columbia University Rating Scale – and 2 disability scales – Northwestern University Disability Scale and Extensive Disability Scale, a new scale conceived for this purpose, which is more accurate in examining in a different way the physical incapacity and handicap of parkinsonian patients in their daily living. The examiners worked in pairs and did not discuss their rating scores before the end of the study. As far as interobserver agreement is concerned, the results of the disability scales are better than those of the rating scales. The Northwestern Disability Scale and the new scale are similar in reliability and consistency; however, the Extensive Disability Scale has proved to be a better indicator of the functional status. We suggest a more extensive employment of disability scales in clinical studies.

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Section: Discussioncontrasting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

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

Ginanneschi

Degl'Innocenti²,

Maurello³

et al. 1991

Neuroepidemiology

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“…While the UPDRS provides an improved instrument for rating PD motor severity compared to the HY scale and has overall better clinimetric properties than other scales, 14 it does not completely overcome the issues of inter-rater variability and subjectivity 15,16 and remains a time consuming rating technique. Hence, although it is the most studied and used scale, it cannot be applied as often as desired to track the progression of the disease.…”

Section: Introductionmentioning

confidence: 99%

Finger tapping movements of Parkinson’s disease patients automatically rated using nonlinear delay differential equations

Lainscsek

Rowat

Schettino

et al. 2012

Chaos: An Interdisciplinary Journal of Nonlinear Science

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Parkinson's disease is a degenerative condition whose severity is assessed by clinical observations of motor behaviors. These are performed by a neurological specialist through subjective ratings of a variety of movements including 10-s bouts of repetitive finger-tapping movements. We present here an algorithmic rating of these movements which may be beneficial for uniformly assessing the progression of the disease. Finger-tapping movements were digitally recorded from Parkinson's patients and controls, obtaining one time series for every 10 s bout. A nonlinear delay differential equation, whose structure was selected using a genetic algorithm, was fitted to each time series and its coefficients were used as a six-dimensional numerical descriptor. The algorithm was applied to time-series from two different groups of Parkinson's patients and controls. The algorithmic scores compared favorably with the unified Parkinson's disease rating scale scores, at least when the latter adequately matched with ratings from the Hoehn and Yahr scale. Moreover, when the two sets of mean scores for all patients are compared, there is a strong (r ¼ 0.785) and significant (p < 0:0015) correlation between them. Parkinson's disease (PD) is a common disease affecting tens of millions of people worldwide. Its cardinal signs are resting tremor, bradykinesia (slowness clumsiness of movement), rigidity, and loss of postural reflexes. The disease evolves slowly and, to adjust medications to the severity of the disease, there is a need for automatic and objective evaluation of movements. Such objective movement assessments would supplement subjective clinical ratings, which are ordinal rather than metric and often show large inter-rater variability. Rather than using a spectral based technique, we rated dynamical features of each individuals' finger-tapping-one of the items from the unified Parkinson's disease rating scale (UPDRS) used for rating the severity of the disease-by using data models based on nonlinear delay differential equations (DDEs). The coefficients of the DDEs are then used to assess the severity of the disease.

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“…The relatively poor reliability reported was attributed not only to the inexperience of the raters, but also to differences in technique employed and interpretation of the scales. Another study evaluating these same two scales with six neurologists from the same center reported only "fair" to "moderate" interrater reliability [7], perhaps an indication of shortcomings in the scales themselves. In any case, differences in the method of rigidity assessment is one source of disagreement between clinicians.…”

Section: Discussionmentioning

confidence: 99%

Quantification of the UPDRS rigidity scale

Patrick

Denington

Gauthier

et al. 2001

IEEE Trans. Neural Syst. Rehabil. Eng.

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Abstract-In the clinical setting, parkinsonian rigidity is assessed using subjective rating scales such as that of the Unified Parkinson's Disease Rating System (UPDRS). However, such scales are susceptible to problems of sensitivity and reliability. Here, we evaluate the reliability and validity of a device designed to quantify parkinsonian rigidity at the elbow and the wrist. The method essentially quantifies the clinical examination and employs small sensors to monitor forces and angular displacements imposed by the clinician onto the limb segment distal to the joint being evaluated. Force and displacement data are used to calculate elastic and viscous stiffnesses and their vectorial sum, mechanical impedance. Interexaminer agreement of measures of mechanical impedance in subjects with Parkinson's disease was comparable to that of clinical UPDRS scores. Examiners tended to overrate rigidity on the UPDRS scale during reinforcement manoeuvres. Mechanical impedance was nonlinearly related to UPDRS ratings of rigidity at the elbow and wrist; characterization of such relationships allows interpretation of impedance measurements in terms of the clinical rating scales.

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Evaluation of Parkinson’s Disease: Reliability of Three Rating Scales

Cited by 41 publications

References 6 publications

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

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

Finger tapping movements of Parkinson’s disease patients automatically rated using nonlinear delay differential equations

Quantification of the UPDRS rigidity scale

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