{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T05:55:11Z","timestamp":1791006911087,"version":"4.1.0"},"reference-count":19,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:00:00Z","timestamp":1790899200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:00:00Z","timestamp":1790899200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The sum of clinician\u2010rated MDS\u2010UPDRS Part III Motor Examination items is widely used in Parkinson's disease (PD), but item\u2010 or subset prognostic value remains unclear. Whereas reduced subsets of patient\u2010reported Parts IB\u2009+\u2009II show improved utility for predicting time to PD medication initiation, the validity of similar Part III subsets is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Determine whether a subset of MDS\u2010UPDRS Part III items is superior in prognostic value to the full scale for time to PD medication initiation in early disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Harmonized longitudinal data from six early PD cohorts, with time to PD medication initiation as the primary outcome, were analyzed using a longitudinal item response theory model to rank items, combining discrimination and information. Rank\u2010driven cumulative subsets were formed to analyze the primary outcome using time\u2010varying Cox models under clinically relevant follow\u2010up windows. Subset performance was assessed using the C\u2010index and compared with the full\u2010item model using Wald tests. Successful item reduction required stable, significant improvement across all follow\u2010up windows.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>No item subset met the predefined criteria for stable and superior prognostic performance relative to the full Part III scale. Best reduced\u2010subset versus full\u2010model C\u2010indices were similar and non\u2010significant: 0.582 versus 0.581 under full follow\u2010up, 0.602 versus 0.602 at 1\u2009year, and 0.586 versus 0.585 at 2\u2009years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Unlike Parts IB and II, no sensitivity\u2010driven reduced subset significantly and consistently outperformed the full MDS\u2010UPDRS Part III in predicting time to PD medication initiation in early PD, not supporting a reduction of the 33\u2010item scale in this setting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mdc3.70843","type":"journal-article","created":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T05:36:11Z","timestamp":1791005771000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Movement Disorder Society Unified Parkinson's Disease Rating Scale Part\n                    <scp>III<\/scp>\n                    cannot Be Reliably Reduced for Predicting Time to Initiation of Parkinsonian Medication in Early Parkinson's Disease: An Item\u2010Level Sensitivity Analysis"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0602-5861","authenticated-orcid":false,"given":"Mohammad Samsul","family":"Alam","sequence":"first","affiliation":[{"name":"Department of Biostatistics &amp; Bioinformatics Duke University  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7905-9336","authenticated-orcid":false,"given":"Glenn T.","family":"Stebbins","sequence":"additional","affiliation":[{"name":"Department of Neurological Sciences Rush University Medical Center  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6973-7479","authenticated-orcid":false,"given":"Tiago A.","family":"Mestre","sequence":"additional","affiliation":[{"name":"Ottawa Hospital Research Institute Brain and Mind Research Institute, University of Ottawa  Ottawa Ontario Canada"},{"name":"Division of Neurology, Department of Medicine University of Ottawa, The Ottawa Hospital  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1665-8205","authenticated-orcid":false,"given":"Christopher G.","family":"Goetz","sequence":"additional","affiliation":[{"name":"Department of Neurological Sciences Rush University Medical Center  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4214-5809","authenticated-orcid":false,"given":"Sheng","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Biostatistics &amp; Bioinformatics Duke University  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,2]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/nrdp.2017.13","article-title":"Parkinson disease","volume":"3","author":"Poewe W","year":"2017","journal-title":"Nat Rev Dis Primers"},{"key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1002\/mds.26913","article-title":"Biomarker\u2010driven phenotyping in Parkinson's disease: a translational missing link in disease\u2010modifying clinical trials","volume":"32","author":"Espay AJ","year":"2017","journal-title":"Mov Disord"},{"key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1002\/mds.22340","article-title":"Movement Disorder Society\u2010sponsored revision of the unified Parkinson's disease rating scale (MDS\u2010UPDRS): scale presentation and clinimetric testing results","volume":"23","author":"Goetz CG","year":"2008","journal-title":"Mov Disord"},{"key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/j.pneurobio.2011.09.005","article-title":"The Parkinson progression marker initiative (PPMI)","volume":"95","author":"Marek K","year":"2011","journal-title":"Prog Neurobiol"},{"key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"1587","DOI":"10.1002\/mds.28110","article-title":"Item response theory analysis of the MDS\u2010UPDRS motor examination: tremor vs. nontremor items","volume":"35","author":"Siqueira Tosin MH","year":"2020","journal-title":"Mov Disord"},{"key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1136\/jnnp-2018-318337","article-title":"Developing and validating Parkinson's disease subtypes and their motor and cognitive progression","volume":"89","author":"Lawton M","year":"2018","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1002\/mds.27361","article-title":"Longitudinal change of clinical and biological measures in early Parkinson's disease: Parkinson's progression markers initiative cohort","volume":"33","author":"Simuni T","year":"2018","journal-title":"Mov Disord"},{"key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/BF03372160","article-title":"Estimation of latent ability using a response pattern of graded scores","volume":"34","author":"Samejima F","year":"1969","journal-title":"Psychometrika"},{"key":"e_1_2_10_10_1","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1002\/mdc3.13311","article-title":"Novel approach to Movement Disorder Society\u2010unified Parkinson's disease rating scale monitoring in clinical trials: longitudinal item response theory models","volume":"8","author":"Luo S","year":"2021","journal-title":"Mov Disord Clin Pract"},{"key":"e_1_2_10_11_1","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1002\/mds.70096","article-title":"Longitudinal evaluation of an abbreviated patient\u2010reported Movement Disorder Society\u2010sponsored revision of the unified Parkinson's disease rating scale (MDS\u2010UPDRS) for predicting dopaminergic therapy initiation in early Parkinson's disease","volume":"41","author":"Alam MS","year":"2025","journal-title":"Mov Disord"},{"key":"e_1_2_10_12_1","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1002\/mdc3.14229","article-title":"Increasing sensitivity in patient\u2010reported MDS\u2010UPDRS items for predicting medication initiation in early PD","volume":"12","author":"Zou H","year":"2025","journal-title":"Mov Disord Clin Pract"},{"key":"e_1_2_10_13_1","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1001\/jama.2021.10207","article-title":"Effect of urate\u2010elevating inosine on early Parkinson disease progression: the SURE\u2010PD3 randomized clinical trial","volume":"326","author":"Schwarzschild MA","year":"2021","journal-title":"JAMA"},{"key":"e_1_2_10_14_1","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1002\/mds.25748","article-title":"Predictors of cognitive impairment in an early stage Parkinson's disease cohort","volume":"29","author":"Hu MT","year":"2014","journal-title":"Mov Disord"},{"key":"e_1_2_10_15_1","doi-asserted-by":"crossref","first-page":"591","DOI":"10.7326\/M19-2534","article-title":"Isradipine versus placebo in early Parkinson disease: a randomized trial","volume":"172","author":"Investigators PSGS\u2010PI","year":"2020","journal-title":"Ann Intern Med"},{"key":"e_1_2_10_16_1","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1056\/NEJMoa2202867","article-title":"Trial of Prasinezumab in early\u2010stage Parkinson's disease","volume":"387","author":"Pagano G","year":"2022","journal-title":"N Engl J Med"},{"key":"e_1_2_10_17_1","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1056\/NEJMoa2203395","article-title":"Trial of cinpanemab in early Parkinson's disease","volume":"387","author":"Lang AE","year":"2022","journal-title":"N Engl J Med"},{"key":"e_1_2_10_18_1","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1002\/mds.25383","article-title":"How to identify tremor dominant and postural instability\/gait difficulty groups with the movement disorder society unified Parkinson's disease rating scale: comparison with the unified Parkinson's disease rating scale","volume":"28","author":"Stebbins GT","year":"2013","journal-title":"Mov Disord"},{"key":"e_1_2_10_19_1","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1002\/mds.23462","article-title":"The impact of non\u2010motor symptoms on health\u2010related quality of life of patients with Parkinson's disease","volume":"26","author":"Martinez\u2010Martin P","year":"2011","journal-title":"Mov Disord"},{"key":"e_1_2_10_20_1","doi-asserted-by":"crossref","DOI":"10.1038\/s41531-025-01072-2","article-title":"Optimizing the MDS\u2010UPDRS part III for early\u2010stage Parkinson's: early supportive evidence for a limb\u2010related bradykinesia\/rigidity sub\u2010score","volume":"11","author":"Regnault A","year":"2025","journal-title":"NPJ Parkinsons Dis"}],"container-title":["Movement Disorders Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mdc3.70843","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/mdc3.70843","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mdc3.70843","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T05:36:14Z","timestamp":1791005774000},"score":1,"resource":{"primary":{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/10.1002\/mdc3.70843"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,2]]},"references-count":19,"alternative-id":["10.1002\/mdc3.70843"],"URL":"https:\/\/doi.org\/10.1002\/mdc3.70843","archive":["Portico"],"relation":{},"ISSN":["2330-1619","2330-1619"],"issn-type":[{"value":"2330-1619","type":"print"},{"value":"2330-1619","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,2]]},"assertion":[{"value":"2026-05-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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