Nogawa Shigeru, Takahashi Hirohide, Hattori Nobutaka
Department of Internal Medicine, Tokyo Dental College Ichikawa General Hospital
Rinsho Shinkeigaku. 2011 May;51(5):321-9. doi: 10.5692/clinicalneurol.51.321.
Patients with Parkinson's disease (PD) suffer from various symptoms. In order to identify untreated symptoms within the limited time of a clinical interview, we developed a new self-completing questionnaire (MASAC-PD 31). The questionnaire consists of two parts (5 domains, 31 items); Part I intended at rating the motor symptoms and activities of daily living (ADL) during both "on" and "off" periods, and Part II aimed at screening and assessing mainly the non-motor symptoms, such as sleep-related difficulties, autonomic symptoms, cognition, mood and others. The purpose of this study was to evaluate the validity, reliability, and clinical usefulness of the questionnaire.
Based on the number of valid answers in a pilot trial, MASAC-PD 31 was refined by improving the expression and layout. Of the initially enrolled 107 patients attending three hospitals, 102 patients were included in the final analysis. Correlations of the scores on the MASAC-PD 31 with other clinical scales were evaluated. A second trial consisting of 57 participants was conducted a month later to assess the test-retest reproducibility of the questionnaire.
The average time needed to complete MASAC-PD 31 was 17 min (range: 3-90 min). Each of the domains in Part I showed high internal consistency (Cronbach's alpha: 0.663 for "on" motor) and strong correlations with preexisting indices (Spearman's correlation coefficient: 0.547, 0.544, and 0.571 for "on" motor against "on" UPDRS, PDQ-39, and Schwab & England ADL scale, respectively). The questions in the Part II domains also showed strong correlations with preexisting scales. Most of the items showed high reproducibility (weighted kappa coefficient) and consistency.
This new comprehensive questionnaire was shown to be valid and reliable for assessing the motor disability in patients with PD. Moreover, it may be useful in clinical management for identifying clinically unrecognized symptoms, especially non-motor problems.
帕金森病（PD）患者存在多种症状。为了在临床问诊的有限时间内识别未治疗的症状，我们开发了一种新的自填式问卷（MASAC-PD 31）。该问卷由两部分组成（5个领域，31个项目）；第一部分旨在对“开”期和“关”期的运动症状及日常生活活动（ADL）进行评分，第二部分主要旨在筛查和评估非运动症状，如睡眠相关困难、自主神经症状、认知、情绪等。本研究的目的是评估该问卷的有效性、可靠性和临床实用性。
根据预试验中的有效答案数量，通过改进表述和布局对MASAC-PD 31进行了完善。最初纳入的来自三家医院的107例患者中，102例患者纳入最终分析。评估了MASAC-PD 31得分与其他临床量表的相关性。一个月后进行了由57名参与者组成的第二项试验，以评估问卷的重测信度。
完成MASAC-PD 31所需的平均时间为17分钟（范围：3 - 90分钟）。第一部分的每个领域均显示出较高的内部一致性（克朗巴哈系数：“开”期运动为0.663），且与现有指标具有强相关性（斯皮尔曼相关系数：“开”期运动与“开”期统一帕金森病评定量表（UPDRS）、帕金森病问卷39项（PDQ-39）和施瓦布与英格兰日常生活活动量表的相关系数分别为0.547、0.544和0.571）。第二部分领域的问题也与现有量表具有强相关性。大多数项目显示出高重测信度（加权kappa系数）和一致性。
这种新的综合问卷被证明对于评估PD患者的运动功能障碍是有效且可靠的。此外，它在临床管理中可能有助于识别临床上未被认识到的症状，尤其是非运动问题。
