Minimal Clinically Important Differences for the Experiences of Daily Living Parts of Movement Disorder Society-Sponsored Unified Parkinson's Disease Rating Scale

作者：Horvath Krisztina; Aschermann Zsuzsanna; Kovacs Marton; Makkos Attila; Harmat Mark; Janszky Jozsef; Komoly Samuel; Karadi Kazmer; Kovacs Norbert

来源：Movement Disorders, 2017, 32(5): 789-793.

DOI：10.1002/mds.26960

• minimal clinically important changes
• minimal but clinically relevant differences
• receiver operating
• characteristic curve
• UPDRS
• patient reported outcomes

Background: The minimal clinically important difference is the smallest change of scores clinically meaningful to patients.
Objectives: We aimed to calculate these threshold values in association with the International Parkinson and Movement Disorder Society UPDRS (MDS-UPDRS) Parts I and II and to evaluate the feasibility of the composite score of Part I and II (MDS-UPDRS I+II) as an outcome.
Methods: Nine hundred eighty-five paired investigations of 365 patients were reviewed, implementing three different techniques simultaneously.
Results: Based on the ordinal regression modeling, the MDS-UPDRS I+II score is an applicable outcome measure. Any improvement greater than 2.64 points or any worsening more than 2.45 points on MDS-UPDRS Part I represent a minimal, yet clinically meaningful change. In reference to Part II, the smallest changes considered clinically relevant were 3.05 and 2.51 points for improvement and deterioration, respectively. The thresholds for MDS-UPDRS I+II were 5.73 points for improvement and 4.70 points for worsening.
Conclusions: Our minimal clinically important difference thresholds can be utilized in clinical practice in judging clinical relevance.

• 出版日期2017-5