Objective: To assess concordance between patient-reported experiences of daily living and clinician-rated motor exam severity in Parkinson’s disease (PD).

Background: Clinicians rate PD motor severity using the Unified Parkinson’s Disease Rating Scale (UPDRS) motor examination (Part III), while patients report how symptoms affect experiences of daily living (Part II). These two perspectives may not always match.

Method: Data were analyzed from the SPOT study at Columbia University. We conducted a cross-sectional analysis of PD participants with both clinician-rated UPDRS motor exam data (Part III; items 18–31) and patient-reported UPDRS experiences of daily living data (Part II; items 5–17). We calculated a clinician motor exam total and a patient-reported daily living total after excluding totals with substantial missing item data. Agreement was measured using Spearman correlation and a linear model. To describe disagreement, we calculated a standardized difference (“Gap”) between the patient total and clinician total and grouped participants as aligned (middle two quartiles) or mismatched (top quartile: patient higher than clinician; bottom quartile: clinician higher than patient).

Results: A total of 1,253 PD participants had both totals available. Patient-reported experiences of daily living and clinician-rated motor exam severity were moderately correlated (Spearman rho = 0.501; p < 0.001). In the linear model, each 1-point increase in clinician-rated motor exam severity was associated with a 0.321-point increase in patient-reported difficulty (p < 0.001; R^2 = 0.326). Half of participants were aligned (626/1,253; 50.0%). The remaining participants showed mismatch in either direction: 314/1,253 (25.1%) had higher clinician-rated severity than patient-reported difficulty, and 313/1,253 (25.0%) had higher patient-reported difficulty than clinician-rated severity.

Conclusion: Patient-reported experiences of daily living and clinician-rated motor exam severity are related, but concordance was observed only half of the time. These findings support incorporating patient-reported experiences of daily living alongside clinician-rated motor exams to better capture PD symptom impact in both clinical trials and routine care.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/agreement-between-patient-reported-experiences-of-daily-living-and-clinician-rated-motor-exam-severity-in-parkinsons-disease/