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It Is as It Was: MDS-UPDRS Part III Scores Cannot Be Combined with Other Parts to Give a Valid Sum
Christopher G Goetz1, Dongrak Choi2, Yuanyuan Guo2
1Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA.
Background:
Original clinimetric analyses by the Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) developers did not confirm the validity of summing the scores of its parts. Recent studies used the summed score of Part III and other parts as efficacy outcomes.
Objective:
The aim of this study was to establish whether summing scores of MDS-UPDRS parts can be recommended.
Methods:
Using 7466 full MDS-UPDRS scores, we applied two-step factor analysis as in the original article to reassess the validity analysis with the threshold criterion set at comparative fit index ≥0.9.
Results:
All comparative fit indexes of any combination including Part III were lower than 0.90.
Conclusions:
Summing Part III MDS-UPDRS scores with other parts is not clinimetrically sound. The MDS-UPDRS is a validated four-part scale with corresponding individual part scores and needs to be used within the limits originally presented. © 2022 International Parkinson and Movement Disorder Society.

