Estimation of and clinical consensus on the meaningful motor progression threshold on MDS-UPDRS Part III.

IF 4 3区 医学 Q2 NEUROSCIENCES
Journal of Parkinson's disease Pub Date : 2025-02-01 Epub Date: 2025-01-14 DOI:10.1177/1877718X241302337
Dylan Trundell, Evan W Davies, Louise Barrett, Stefano Zanigni, Nima Shariati, Rebecca Rogers, Annabelle Monnet, Emma Moore, Nathalie Pross, Gennaro Pagano, Stefan Cano, Tania Nikolcheva
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Abstract

BackgroundTo understand changes in the underlying progression of early Parkinson's disease, it is important to derive estimates of the threshold for meaningful motor progression on the MDS-UPDRS Part III in OFF medication state.ObjectiveTo estimate this threshold using two approaches: anchor-based analyses, and clinical consensus via a modified Delphi panel.MethodsFor the anchor-based analyses, data from a Phase II clinical trial were used. Mean and median MDS-UPDRS Part III change scores were calculated for those participants rated as 'Minimally worse' on the Clinical Global Impression of Improvement (using the first visit rated as 'Minimally worse' or worse, and at Weeks 24 and 52). Cumulative data up to Week 104 were used to assess the difference between motor progressors' and non-progressors' change scores on motor-related outcomes. For the modified Delphi panel, a panel of 13 expert clinicians received an online survey in two rounds and provided responses anonymously.ResultsFor the anchor-based analyses, estimates of meaningful change ranged from 4-6 points. Numerically worse change scores were identified on motor-related outcomes for participants who had experienced motor progression compared with those who had not. For the modified Delphi panel, consensus was reached in Round 2, with 92% agreeing that 5 points is suitable to define a clinically meaningful motor progression threshold.ConclusionsResults of the anchor-based analyses and modified Delphi panel were consistent, supporting a meaningful motor progression threshold of a worsening of 5 points on the MDS-UPDRS Part III (OFF medication state) in an early Parkinson's disease population.

MDS-UPDRS中有意义运动进展阈值的估计和临床共识(第三部分)。
背景:为了了解早期帕金森病潜在进展的变化,重要的是得出MDS-UPDRS第三部分在关闭药物状态下有意义的运动进展阈值的估计。目的:使用两种方法来估计这个阈值:基于锚定的分析和通过改进的德尔菲小组的临床共识。方法:基于锚点的分析,数据来自II期临床试验。MDS-UPDRS第三部分改变评分的平均值和中位数是为那些在临床总体改善印象中被评为“最低程度恶化”的参与者计算的(使用第一次就诊被评为“最低程度恶化”或更糟,在第24周和第52周)。截至第104周的累积数据用于评估运动进展者和非进展者在运动相关结果的变化评分之间的差异。对于修改后的德尔福小组,由13名临床专家组成的小组接受了两轮在线调查,并匿名提供了回答。结果:对于基于锚点的分析,估计有意义的变化范围为4-6点。与没有运动进展的参与者相比,经历运动进展的参与者在运动相关结果上的数字变化得分更差。对于修改后的Delphi panel,在第2轮中达成共识,92%的人同意5分适合定义有临床意义的运动进展阈值。结论:基于锚点的分析和改进的德尔菲面板的结果是一致的,支持MDS-UPDRS第三部分(OFF药物状态)在早期帕金森病患者中恶化5分的有意义的运动进展阈值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
8.40
自引率
5.80%
发文量
338
审稿时长
>12 weeks
期刊介绍: The Journal of Parkinson''s Disease (JPD) publishes original research in basic science, translational research and clinical medicine in Parkinson’s disease in cooperation with the Journal of Alzheimer''s Disease. It features a first class Editorial Board and provides rigorous peer review and rapid online publication.
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