Category: Education in Movement Disorders
Objective: To evaluate the clinical applicability of the Global Assessment Scale for Wilson’s Disease (GAS-WD) in the Brazilian context.
Background:
Wilson’s disease (WD) is a rare autosomal recessive disorder of copper metabolism leading to progressive hepatic and neurological impairment. The GAS-WD is a validated tool for assessing neurological severity in WD; however, no Brazilian Portuguese version was available, and its suitability for the Brazilian context had not been examined.
Method: Two movement disorder specialists independently evaluated each GAS-WD item to identify potential barriers to its applicability in Brazil, based on their clinical experience with populations from diverse socioeconomic backgrounds and varying levels of health literacy. Two additional movement disorder neurologists independently translated the GAS-WD into Brazilian Portuguese. The versions were compared and harmonized by consensus. Linguistic correspondence was quantified by percentage agreement, and semantic equivalence was verified through back-translation by a native English speaker.
Results: Both translations showed high fidelity to the original, with a linguistic correspondence rate of 94% and back-translation compatibility of 98%, confirming strong semantic equivalence. In the applicability phase, the first specialist flagged issues in 32.67% of items and the second in 31.68%, with overlapping concerns in 26.26%. Post-discussion consensus identified problematic items in 29.7% of the total.
Conclusion: The GAS-WD achieved excellent linguistic and semantic equivalence in Brazilian Portuguese. However, the applicability assessment revealed significant barriers to clinical use in Brazil, including low health literacy, limited caregiver involvement, and item subjectivity. Future work should prioritize instruments with objective criteria and culturally appropriate content for the Brazilian healthcare context.
References: AGGARWAL, A. et al. A novel Global Assessment Scale for Wilson’s Disease (GAS for WD). Movement Disorders, v. 24, n. 4, p. 509–518, 15 mar. 2009.
BANDMANN, O.; WEISS, K. H.; KALER, S. G. Wilson’s disease and other neurological copper disorders. The Lancet Neurology, v. 14, n. 1, p. 103–113, jan. 2015.
To cite this abstract in AMA style:
A. Oliveira Santos, I. Cerqueira, M. da Silva, B. Smith, L. Fonseca Matta, L. Silveira-Moriyama. Gauging The Applicability Of The Global Assessment Scale for Wilson’s Disease in Brazil [abstract]. Mov Disord. 2026; 41 (suppl 1). https://www.mdsabstracts.org/abstract/gauging-the-applicability-of-the-global-assessment-scale-for-wilsons-disease-in-brazil/. Accessed October 1, 2026.« Back to 2026 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/gauging-the-applicability-of-the-global-assessment-scale-for-wilsons-disease-in-brazil/