Movement Disorder Society‐sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS‐UPDRS): Process, format, and clinimetric testing plan

Abstract

Abstract This article presents the revision process, major innovations, and clinimetric testing program for the Movement Disorder Society (MDS)–sponsored revision of the Unified Parkinson's Disease Rating Scale (UPDRS), known as the MDS‐UPDRS. The UPDRS is the most widely used scale for the clinical study of Parkinson's disease (PD). The MDS previously organized a critique of the UPDRS, which cited many strengths, but recommended revision of the scale to accommodate new advances and to resolve problematic areas. An MDS‐UPDRS committee prepared the revision using the recommendations of the published critique of the scale. Subcommittees developed new material that was reviewed by the entire committee. A 1‐day face‐to‐face committee meeting was organized to resolve areas of debate and to arrive at a working draft ready for clinimetric testing. The MDS‐UPDRS retains the UPDRS structure of four parts with a total summed score, but the parts have been modified to provide a section that integrates nonmotor elements of PD: I, Nonmotor Experiences of Daily Living; II, Motor Experiences of Daily Living; III, Motor Examination; and IV, Motor Complications. All items have five response options with uniform anchors of 0 = normal, 1 = slight, 2 = mild, 3 = moderate, and 4 = severe. Several questions in Part I and all of Part II are written as a patient/caregiver questionnaire, so that the total rater time should remain approximately 30 minutes. Detailed instructions for testing and data acquisition accompany the MDS‐UPDRS in order to increase uniform usage. Multiple language editions are planned. A three‐part clinimetric program will provide testing of reliability, validity, and responsiveness to interventions. Although the MDS‐UPDRS will not be published until it has successfully passed clinimetric testing, explanation of the process, key changes, and clinimetric programs allow clinicians and researchers to understand and participate in the revision process. © 2006 Movement Disorder Society

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Affiliated Institutions

• Rush University Medical Center US
• University of Massachusetts Chan Medical School US
• Sorbonne Université FR
• University of Illinois Chicago US
• University College London GB
• Columbia University US
• Instituto de Salud Carlos III ES
• University of Rochester US
• Weston College GB
• University of Bonn DE
• University of Toronto CA
• Innsbruck Medical University AT
• Pitié-Salpêtrière Hospital FR
• University of Pennsylvania US
• Hospital de Sant Pau ES
• Pharmacochimie et Pharmacologie pour le Développement FR
• Leiden University NL
• University of Lisbon PT
• Medical University of South Carolina US
• Wayne State University US
• Icahn School of Medicine at Mount Sinai US
• Baylor College of Medicine US

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