Abstract Details

Title MDS-UPDRS ratings for Parkinson’s Disease in the COVID-19 setting

Topic Movement Disorders

Presentation(s) Movement Disorders Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 070

Objective In the context of the COVID-19 pandemic where telemedicine widely substitutes for in-office monitoring of Parkinson’s disease (PD), we assessed if the MDS-UPDRS Part III (Motor Examination) taken without ratings that require in-office scoring can provide an accurate surrogate summary score.

Background Although the MDS-UPDRS is the standard rating measure for PD motor severity, in telemedicine, the clinician cannot assess rigidity or postural reflexes. If these scores can be dropped or imputed, the MDS-UPRDS can potentially continue to be used even with telemedicine.

Design/Methods The IPMDS database collected over 6,000 complete MDS-UPDRS assessments on PD patients as part of an international translation effort for the scale. Using these complete assessments, we randomly and selectively deleted item scores. We used Lin's Concordance Correlation Coefficient (CCC) to compare scores calculated without missing values with prorated scores based on sequentially increasing missing values. The maximal number of missing values retaining a CCC greater than 0.95 determined the threshold for rendering a valid prorated score.

Results Given that telemedicine does not allow the assessment of rigidity (five measures) and postural reflexes for safety purposes, we target the situation of six consistent missing values. The Motor Examination, when applied across all Hoehn and Yahr stages, can accommodate the consistent loss of only three missing values on any given visit and still allow the calculation of a calibrated total score with a CCC > 0.95.

Conclusions Telemedicine may provide excellent doctor-patient contact and allow for sufficient informational sharing to care for PD patients in the COVID-19 era, but the MDS-UPDRS cannot be directly applied in this setting with expectations of equivalency to office assessments.

Authors/Disclosures
Christopher Goetz, MD, F�鶹��ýӳ�� (Rush University Medical Center) PRESENTER	The institution of Dr. Goetz has received research support from Michael J. Fox Foundation. The institution of Dr. Goetz has received research support from NIH. The institution of Dr. Goetz has received research support from Department of Defense. Dr. Goetz has received publishing royalties from a publication relating to health care. Dr. Goetz has received publishing royalties from a publication relating to health care. Dr. Goetz has received publishing royalties from a publication relating to health care.
Glenn T. Stebbins, PhD (Rush University Medical Center)	Dr. Stebbins has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Stebbins has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Partners Healthcare System. Dr. Stebbins has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for CHDI. The institution of Dr. Stebbins has received research support from Department of Defense. Dr. Stebbins has received research support from Cleveland Clinic Health Systems. Dr. Stebbins has received personal compensation in the range of $500-$4,999 for serving as a Course Director with MDS.
	No disclosure on file

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