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We developed composite biomarkers to detect levodopa\/carbidopa effects and to estimate PD symptom severity. For this development, we trained machine learning algorithms to select the optimal combination of finger tapping task features to predict treatment effects and disease severity. Data were collected during a placebo\u2010controlled, crossover study with 20 PD patients. The alternate index and middle finger tapping (IMFT), alternative index finger tapping (IFT), and thumb\u2013index finger tapping (TIFT) tasks and the Movement Disorder Society\u2010Unified Parkinson's Disease Rating Scale (MDS\u2010UPDRS) III were performed during treatment. We trained classification algorithms to select features consisting of the MDS\u2010UPDRS III item scores; the individual IMFT, IFT, and TIFT; and all three tapping tasks collectively to classify treatment effects. Furthermore, we trained regression algorithms to estimate the MDS\u2010UPDRS III total score using the tapping task features individually and collectively. The IFT composite biomarker had the best classification performance (83.50% accuracy, 93.95% precision) and outperformed the MDS\u2010UPDRS III composite biomarker (75.75% accuracy, 73.93% precision). It also achieved the best performance when the MDS\u2010UPDRS III total score was estimated (mean absolute error: 7.87, Pearson's correlation: 0.69). We demonstrated that the IFT composite biomarker outperformed the combined tapping tasks and the MDS\u2010UPDRS III composite biomarkers in detecting treatment effects. This provides evidence for adopting the IFT composite biomarker for detecting antiparkinsonian treatment effect in clinical trials. \u00a9 2023 The Authors. <jats:italic>Movement Disorders<\/jats:italic> published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.<\/jats:p>","DOI":"10.1002\/mds.29520","type":"journal-article","created":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T03:18:51Z","timestamp":1688440731000},"page":"1795-1805","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Treatment Detection and Movement Disorder Society\u2010Unified Parkinson's Disease Rating Scale, Part III Estimation Using Finger Tapping Tasks"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1413-1648","authenticated-orcid":false,"given":"Ahnjili","family":"ZhuParris","sequence":"first","affiliation":[{"name":"Centre for Human Drug Research (CHDR)  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