Park Jinse, Jang Wooyoung, Youn Jinyoung, Oh Eungseok, Park Suyeon, Oh Yoonsang, Kim Hee-Tae, Lim Soohyun
Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
Department of Neurology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.
J Clin Neurol. 2024 Sep;20(5):487-492. doi: 10.3988/jcn.2023.0339.
The wearing-off (WO) phenomenon is the most common motor complication in advanced Parkinson's disease (PD), but its identification remains challenging. The 9- and 19-item Wearing-off Questionnaires (WOQ-9 and WOQ-19) are self-assessment tools for motor and nonmotor symptoms that are widely used for WO screening. We produced Korean versions of the WOQ-19 and WOQ-9 (K-WOQ-19 and K-WOQ-9) and investigated their validity and reliability.
We used the translation-back translation method to produce K-WOQ-19 and K-WOQ-9, which were self-administered by 124 patients with PD. We conducted in-depth 10-minute interviews for confirming the presence of the WO phenomenon, and then stratified the participants into groups with and without WO. Diagnostic accuracy was assessed byanalyzing receiver operating characteristic curves. Concurrent validity was assessed using the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) andthe Hoehn and Yahr stage with Spearman's rank correlation analysis. Reliability was assessedbased on test-retest Cohen's kappa (κ) values and intraclass correlation coefficients (ICCs).
The optimal cutoff scores on the K-WOQ-19 and K-WOQ-9 for WO screening were 4 and 2, respectively. The test-retest ICCs of K-WOQ-19 and K-WOQ-9 were 0.943 and 0.938, respectively. Nineteen of the combined 20 items in K-WOQ-19 and K-WOQ-9 showed moderate-to-substantial agreement (κ=0.412-0.771, <0.001). The scores on the translated scales were significantly correlated with MDS-UPDRS IV scores.
K-WOQ-19 and K-WOQ-9 are reliable and valid tools for detecting WO, with optimal cutoff scores of 4 and 2, respectively.
剂末现象（WO）是晚期帕金森病（PD）最常见的运动并发症，但其识别仍具有挑战性。9项和19项剂末现象问卷（WOQ-9和WOQ-19）是用于运动和非运动症状的自我评估工具，广泛用于WO筛查。我们制作了WOQ-19和WOQ-9的韩语版本（K-WOQ-19和K-WOQ-9），并对其有效性和可靠性进行了研究。
我们采用翻译回译法制作K-WOQ-19和K-WOQ-9，由124例PD患者自行填写。我们进行了10分钟的深入访谈以确认WO现象的存在，然后将参与者分为有和无WO的组。通过分析受试者工作特征曲线评估诊断准确性。使用运动障碍协会统一帕金森病评定量表（MDS-UPDRS）和Hoehn-Yahr分期，通过Spearman等级相关分析评估同时效度。基于重测Cohen's kappa（κ）值和组内相关系数（ICC）评估可靠性。
K-WOQ-19和K-WOQ-9用于WO筛查的最佳截断分数分别为4分和2分。K-WOQ-19和K-WOQ-9的重测ICC分别为0.943和0.938。K-WOQ-19和K-WOQ-9的20项合并项目中有19项显示出中度至高度一致性（κ=0.412-0.771，P<0.001）。翻译量表的分数与MDS-UPDRS IV分数显著相关。
K-WOQ-19和K-WOQ-9是检测WO的可靠且有效的工具，最佳截断分数分别为4分和2分。
