{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T22:07:40Z","timestamp":1792447660125,"version":"4.5.0"},"reference-count":35,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,1,9]],"date-time":"2023-01-09T00:00:00Z","timestamp":1673222400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P30AG028716"],"award-info":[{"award-number":["P30AG028716"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P30AG072958"],"award-info":[{"award-number":["P30AG072958"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG064803"],"award-info":[{"award-number":["R01AG064803"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Regulatory recommendations favor outcomes combining objective and patient input. The Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS\u2010UPDRS), the most commonly used scale in Parkinson's disease (PD), includes patient and investigator ratings in distinct parts, but original clinimetric analyses failed to confirm the validity of combining parts by simple summing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The aim was to develop clinimetrically valid constructs for combining patient\u2010reported Part 2 and investigator\u2010rated Part 3 MDS\u2010UPDRS scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using 7888 MDS\u2010UPDRS scores, we assessed construct validity of combined Part 2 and Part 3 items using exploratory factor analysis (EFA) and graded item response theory (IRT) with threshold criteria: comparative fit index\u00a0\u22650.9 (EFA) and discrimination parameters\u00a0\u22650.65 (IRT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The direct sum of Parts 2\u00a0+\u00a03 failed to meet the threshold for a valid outcome of PD severity (comparative fit index, CFI\u00a0=\u00a00.855). However, a two\u2010domain construct combining item scores for tremor and non\u2010tremor domains from Parts 2 and 3 confirmed validity, meeting both EFA and IRT criteria as distinct but correlated indices of disease severity (CFI\u00a0=\u00a00.923; discrimination mean 2.197\u2009\u00b1\u20090.480 [tremor] and 1.737\u2009\u00b1\u20090.344 [non\u2010tremor] domains).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The sum of Parts 2\u00a0+\u00a03 is not clinimetrically sound. However, considering tremor and non\u2010tremor items of both Parts 2 and 3 as two outcomes results in a valid summary of PD motor severity that leverages simultaneous patient\u2010 and investigator\u2010derived measures. This analytic application addresses regulatory prioritizations and retains the well\u2010validated MDS\u2010UPDRS items. In future interventional trials, we suggest that tremor and non\u2010tremor components of PD motor severity from Parts 2\u00a0+\u00a03 be monitored and analyzed to accurately detect objective changes that integrate the patient's voice. \u00a9 2023 International Parkinson and Movement Disorder Society.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mds.29308","type":"journal-article","created":{"date-parts":[[2023,1,9]],"date-time":"2023-01-09T11:00:40Z","timestamp":1673262040000},"page":"453-463","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Using Movement Disorder Society Unified Parkinson's Disease Rating Scale Parts 2 and 3 Simultaneously: Combining the Patient Voice with Clinician Ratings"],"prefix":"10.1002","volume":"38","author":[{"given":"Yuanyuan","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Biostatistics &amp; Bioinformatics Duke University  Durham North Carolina 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