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Item Open Access Resolving Missing Data from the Movement Disorder Society Unified Parkinson's Disease Rating Scale: Implications for Telemedicine.(Movement disorders : official journal of the Movement Disorder Society, 2022-06-18) Luo, Sheng; Goetz, Christopher G; Choi, Dongrak; Aggarwal, Sanket; Mestre, Tiago A; Stebbins, Glenn TBackground
Telemedicine has become standard in clinical care and research during the coronavirus disease 2019 pandemic. Remote administration of Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part III (Motor Examination) precludes ratings of all items, because Rigidity and Postural Stability (six scores) require in-person rating.Objective
The objective of this study was to determine imputation accuracy for total-sum and item-specific MDS-UPDRS Motor Examination scores in remote administration.Methods
We applied multivariate imputation by chained equations techniques in a cross-sectional dataset where patients had one MDS-UPDRS rating (International Translational Program, n = 8,588) and in a longitudinal dataset where patients had multiple ratings (Rush Program, n = 396). Successful imputation was stringently defined as (1) generalized Lin's concordance correlation coefficient >0.95, reflecting near-perfect agreement between total-sum score with complete data and surrogate score, calculated without patients' actual Rigidity and Postural Stability scores; and (2) perfect agreement for item-level scores for Rigidity and Postural Stability items.Results
For total-sum score when Rigidity and Postural Stability scores were withdrawn, using one or multiple visits, multivariate imputation by chained equations imputation reached near-perfect agreement with the original total-sum score. However, at the item level, the degree of perfect agreement between the surrogate and actual Rigidity items and Postural Stability scores always fell below threshold.Conclusions
The MDS-UPDRS Part III total-sum score, a key clinical outcome in research and in clinical practice, can be accurately imputed without the Rigidity and Postural Stability items that cannot be rated by telemedicine. No formula, however, allows for specific item-level imputation. When Rigidity and Postural Stability item scores are of key clinical or research interest, patients with PD must be scored in person. © 2022 International Parkinson and Movement Disorder Society.Item Open Access Validation of the Polish version of the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS).(Neurologia i neurochirurgia polska, 2020-07-08) Siuda, Joanna; Boczarska-Jedynak, Magdalena; Budrewicz, Sławomir; Dulski, Jarosław; Figura, Monika; Fiszer, Urszula; Gajos, Agata; Gorzkowska, Agnieszka; Koziorowska-Gawron, Ewa; Koziorowski, Dariusz; Krygowska-Wajs, Anna; Rudzińska-Bar, Monika; Sławek, Jarosław; Ren, Xuehan; Luo, Sheng; Martinez-Martin, Pablo; Stebbins, Glenn; Goetz, Christopher G; Opala, Grzegorz; MDS-UPDRS Polish Validation Task ForceBACKGROUND:In 2008, the Movement Disorders Society (MDS) published a new Unified Parkinson's Disease Rating Scale (MDS-UPDRS) as the official benchmark scale for Parkinson's Disease (PD). We have translated and validated the Polish version of the MDS-UPDRS, explored its dimensionality, and compared it to the original English one. METHODS:The MDS-UPDRS was translated into Polish by a team of Polish investigators led by JS and GO. The back-translation was completed by colleagues fluent in both languages (Polish and English) who were not involved in the original translation, and was reviewed by members of the MDS Rating Scales Programme. Then the translated version of the MDS-UPDRS underwent cognitive pretesting, and the translation was modified based on the results. The final translation was approved as the Official Working Document of the MDS-UPDRS Polish version, and was tested on 355 Polish PD patients recruited at movement disorders centres all over Poland (at Katowice, Gdańsk, Łódź, Warsaw, Wrocław, and Kraków). Confirmatory and explanatory factor analyses were applied to determine whether the factor structure of the English version could be confirmed in the Polish version. RESULTS:The Polish version of the MDS-UPDRS showed satisfactory clinimetric properties. The internal consistency of the Polish version was satisfactory. In the confirmatory factor analysis, all four parts had greater than 0.90 comparative fit index (CFI) compared to the original English MDS-UPDRS. Explanatory factor analysis suggested that the Polish version differed from the English version only within an acceptable range. CONCLUSIONS AND CLINICAL IMPLICATIONS:The Polish version of the MDS-UPDRS meets the requirements to be designated as the Official Polish Version of the MDS-UPDRS, and is available on the MDS web page. We strongly recommend using the MDS-UPDRS instead of the UPDRS for research purposes and in everyday clinical practice.