Objective: Our aim is to evaluate the feasibility of various composite scores based on the Movement Disorder Society-sponsored Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) as potential clinical outcome measures and subsequently determined their minimal clinically important difference threshold values.

Background: Although the developers did not recommend the usage of composite scores, numerous PD-related studies utilize MDS-UPDRS-based composite scores as their outcome measure. The justification for using each Part score independently is based on the clinimetric properties of the scale. However, in the clinical practice and experimental studies, there may be important reasons to combine the outcomes. Utilizing composite scores may generally provide a broader assessment of PD; however, the combination of the domains may weaken the specificity.

Methods: 1113 paired investigations of 452 patients were reviewed implementing three different techniques simultaneously.

Results: Based on the ordinal regression modeling, the MDS-UPDRS II+III, MDS-UPDRS I+II+III, and the total score of MDS-UPDRS are clinically applicable outcome measures. Any improvement greater than 4.9 points or any worsening more than 4.2 points on MDS-UPDRS II+III represent a minimal, yet clinically meaningful change. In reference to MDS-UPDRS I+II+III, the smallest changes considered clinically relevant were 6.7 and 5.2 points for improvement and deterioration, respectively. The thresholds for the total score of MDS-UPDRS were 7.1 points for improvement and 6.3 points for worsening

Conclusions: Employing ordinal regression modeling, we demonstrated that these composite scores including the total score are clinically applicable and responsive to changes. Subsequently, we calculated the minimally required magnitude of changes in these composite scores.

References: Horvath K, Aschermann Z, Kovacs M, et al. Minimal clinically important differences for the experiences of daily living parts of movement disorder society-sponsored unified Parkinson’s disease rating scale. Mov Disord 2017;32(5):789-793. Horvath K, Aschermann Z, Acs P, et al. Minimal clinically important difference on the Motor Examination part of MDS-UPDRS. Parkinsonism Relat Disord 2015;21(12):1421-1426.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/are-the-mds-updrs-based-composite-scores-clinically-applicable/