Are the MDS‐UPDRS–Based Composite Scores Clinically Applicable?

Abstract Background: The International Parkinson and Movement Disorder Society–sponsored UPDRS (MDS‐UPDRS) is a powerful clinical outcome measure. Objectives: To evaluate the feasibility of various MDS‐UPDRS‐based composite scores and determine their minimal clinically important difference threshold values. Methods: Overall, 1,113 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: Our findings support the application of various MDS‐UPDRS–based composite scores. © 2018 International Parkinson and Movement Disorder Society