Longitudinal Metric Properties of Disability Rating Scales for Parkinson's Disease

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• 作者：Pablo Martinez-Martin ; MD ; PhD^a ; ^{pmartinez@isciii.es} ; Luis Prieto ; MSc ; PhD^b ; Maria Joã ; o Forjaz ; MSc ; PhD^a
• 关键词：Hoehn and Yahr Scale ; ISAPD ; Longitudinal metric properties ; Parkinson's disease ; Schwab and England Scale ; UPDRS
• 刊名：Value in Health
• 出版年：2006
• 出版时间：November-December 2006
• 年：2006
• 卷：9
• 期：6
• 页码：386-393
• 全文大小：94 K

文摘

Objectives

This study analyzes the longitudinal metric attributes of three Parkinson's disease (PD) disability scales, taking Hoehn and Yahr (HY) staging as the reference measure of PD progression.

Methods

A sample of 87 PD patients was assessed during regular medical visits, using the HY, the Unified Parkinson's Disease Rating Scale¡ªActivities of Daily Living Section (UPDRS-ADL), the Schwab and England Scale (SES), and the Intermediate Scale for Assessment of PD (ISAPD), across a follow-up period of 2.6 ¡À 1.0 years.

Results

The following cross-sectional attributes were analyzed, at baseline and again on conclusion of the study: floor and ceiling effects, convergent validity, reliability, and standard error of measurement, all of which were found to be adequate. Longitudinal reproducibility values (intraclass correlation coefficient) were 0.81 (ISAPD) to 0.84 (UPDRS-ADL). Insofar as longitudinal validity was concerned, the change scores of the three disability scales correlated significantly with the HY change score, |r| = 0.33 to 0.45, P < 0.003. Slightly lower values were found when taking the annual rate of change, |r| = 0.20 to 0.36. The three scales were acceptable, even though there were small differences among them. The ¡°minimal clinically important difference?proposed for these scales is: SES, ?; UPDRS-ADL, +2; ISAPD, +1.5 points.

Conclusions

The three scales proved adequate for longitudinal assessment of PD disability. UPDRS-ADL was more precise and ISAPD more consistent. Magnitude of change and correlation with change in HY were slightly higher with the ISAPD. Effect size and standardized response mean for the minimal change in HY were higher for the UPDRS-ADL.