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MDS-UPDRS运动检查部分的最小临床重要差异。

Minimal clinically important difference on the Motor Examination part of MDS-UPDRS.

作者信息

Horváth Krisztina, Aschermann Zsuzsanna, Ács Péter, Deli Gabriella, Janszky József, Komoly Sámuel, Balázs Éva, Takács Katalin, Karádi Kázmér, Kovács Norbert

机构信息

Doctoral School of Clinical Neuroscience, University of Pécs, Pécs, Hungary.

Doctoral School of Clinical Neuroscience, University of Pécs, Pécs, Hungary; Department of Neurology, University of Pécs, Pécs, Hungary.

出版信息

Parkinsonism Relat Disord. 2015 Dec;21(12):1421-6. doi: 10.1016/j.parkreldis.2015.10.006. Epub 2015 Oct 22.

DOI:10.1016/j.parkreldis.2015.10.006

PMID:26578041

Abstract

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.

摘要

背景

近期研究越来越多地使用运动障碍协会赞助的统一帕金森病评定量表（MDS-UPDRS）。然而，MDS-UPDRS的最小临床重要差异（MCID）尚未完全确定。

目的

评估MDS-UPDRS运动检查（第三部分）的MCID阈值。

方法

纳入了260例患者的728对调查。每次就诊时均评估MDS-UPDRS和临床医生报告的整体印象改善量表（CGI-I）。将与CGI-I评分为4（无变化）相关的MDS-UPDRS运动检查（ME）评分变化与与CGI-I评分为3（最小改善）和CGI-I评分为5（最小恶化）相关的MDS-UPDRS ME评分变化进行比较。采用基于锚定和分布的技术来确定MCID的大小。