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Minimal clinically important difference on the Motor Examination part of MDS-UPDRS
Krisztina Horváth1, Zsuzsanna Aschermann2, Péter Ács3
1Doctoral School of Clinical Neuroscience, University of Pécs, Pécs, Hungary.
Background:
Recent studies increasingly utilize the Movement Disorders Society Sponsored Unified Parkinson's Disease Rating Scale (MDS-UPDRS). However, the minimal clinically important difference (MCID) has not been fully established for MDS-UPDRS yet.
Objective:
To assess the MCID thresholds for MDS-UPDRS Motor Examination (Part III).
Methods:
728 paired investigations of 260 patients were included. At each visit both MDS-UPDRS and Clinician-reported Global Impression-Improvement (CGI-I) scales were assessed. MDS-UPDRS Motor Examination (ME) score changes associated with CGI-I score 4 (no change) were compared with MDS-UPDRS ME score changes associated with CGI-I score 3 (minimal improvement) and CGI-I score 5 (minimal worsening). Both anchor- and distribution-based techniques were utilized to determine the magnitude of MCID.
Results:
The MCID estimates for MDS-UPDRS ME were asymmetric: -3.25 points for detecting minimal, but clinically pertinent, improvement and 4.63 points for observing minimal, but clinically pertinent, worsening.
Conclusions:
MCID is the smallest change of scores that are clinically meaningful to patients. These MCID estimates may allow the judgement of a numeric change in MDS-UPDRS ME on its clinical importance.
Insights
The minimal clinically important difference (MCID) for the Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Motor Examination was established. A change of -3.25 points indicates improvement, while 4.63 points indicate worsening.
Area of Science:
- Neurology
- Clinical Assessment
- Parkinson's Disease Research
Background:
- The Movement Disorders Society Sponsored Unified Parkinson's Disease Rating Scale (MDS-UPDRS) is widely used.
- Establishing the minimal clinically important difference (MCID) for the MDS-UPDRS is crucial for clinical interpretation.
Purpose of the Study:
- To determine the MCID thresholds for the MDS-UPDRS Motor Examination (Part III).
- To provide clinically meaningful benchmarks for assessing Parkinson's disease progression and treatment efficacy.
Main Methods:
- Analysis of 728 paired investigations from 260 Parkinson's disease patients.
- Utilized both anchor-based (Clinician-reported Global Impression-Improvement scale) and distribution-based techniques.
- Compared MDS-UPDRS Motor Examination score changes against patient-reported global improvement.
Main Results:
- Asymmetric MCID estimates were found for the MDS-UPDRS Motor Examination.
- A change of -3.25 points was identified as the MCID for minimal clinically important improvement.
- A change of 4.63 points was identified as the MCID for minimal clinically important worsening.
Conclusions:
- The established MCID values provide a quantitative measure of clinical meaningfulness for MDS-UPDRS Motor Examination score changes.
- These findings aid clinicians in interpreting the significance of score fluctuations in Parkinson's disease patients.
- The MCID helps in judging the clinical importance of numerical changes in the MDS-UPDRS Motor Examination.
