Reliability of the columbia scale for assessing signs of parkinson's disease

Abstract

Inter- and intrarater reliability in scoring the signs of Parkinson's disease using the original Columbia scale and a modified version of this, the Sydney scale, were assessed in five neurologists participating in a long-term study of Parkinson's disease. Scoring was done on video recordings of 41 patients whose disability ranged from mild to severe. Although all the neurologists were familiar with the scales and had received training designed to produce uniformity of scoring, interrater reliability was poor. The mean score for the Columbia scale varied from 18.6 to 30 and for the Sydney scale from 15.2 to 23.2. By contrast, intrarater reliability was good. This study highlights the limitations of clinical rating scales in Parkinson's disease when more than one rater is used. In designing clinical trials, every effort should be made to ensure that the same patient is always assessed by the same rater.

Global versus factor‐related impression of severity in Parkinson's disease: A new clinimetric index (CISI‐PD)

“…23 Both the original scale and the modified version incorporated into the UPDRS have only been partially validated. 5,[33][34][35][36] The Schwab and England scale 16 is extensively used, yet it has never been formally tested and standardized, with the result that a degree of uncertainty surrounds its reliability. 37 Its convergent validity has, however, been indirectly assessed and considered satisfactory.…”

Gait quantitation in Parkinson's disease ? locomotor disability and correlation to clinical rating scales

“…Remarkably, the interrater agreement in assessing gait patterns is high in PD and also in other gait disorders of the elderly (Henderson et al, 1991;Hely et al, 1993;Vieregge et al, 1996a). In contrast, the overall interrater agreement in the PD-related rating scales varies: It has been found "substantial" (Geminiani et al, 1991) to "moderate" (Ginanneschi et al, 1988) for the scores of the Hoehn and Yahr (Hoehn and Yahr, 1967) as well as Columbia University Rating Scale (CURS; Duvoisin et al, 1971), but also "poor" for the latter (Hely et al, 1993). Interrater agreement was "moderate" for the Webster Rating Scale (Webster, 1968;Ginanneschi et al, 1988;Geminiani et al, 1991).…”

Clinical significance of extrapyramidal signs in patients with cirrhosis

“…The presence of extrapyramidal signs was evaluated using the Unified Parkinson's Disease Rating Scale (UPDRS) parts 1, 2 and 3, a scale that derives from the Columbia scale [25]. The UPDRS is the currently accepted method for evaluation of parkinsonism and it is a validated scale with excellent interrater reliability [26,27].…”