Movement Disorder Society Task Force report on the Hoehn and Yahr staging scale: Status and recommendations The Movement Disorder Society Task Force on rating scales for Parkinson's disease
Identifieur interne : 001C28 ( Main/Corpus ); précédent : 001C27; suivant : 001C29Movement Disorder Society Task Force report on the Hoehn and Yahr staging scale: Status and recommendations The Movement Disorder Society Task Force on rating scales for Parkinson's disease
Auteurs : Christopher G. Goetz ; Werner Poewe ; Olivier Rascol ; Cristina Sampaio ; Glenn T. Stebbins ; Carl Counsell ; Nir Giladi ; Robert G. Holloway ; Charity G. Moore ; Gregor K. Wenning ; Melvin D. Yahr ; Lisa SeidlSource :
- Movement Disorders [ 0885-3185 ] ; 2004-09.
English descriptors
Abstract
The Movement Disorder Society Task Force for Rating Scales for Parkinson's disease (PD) prepared a critique of the Hoehn and Yahr scale (HY). Strengths of the HY scale include its wide utilization and acceptance. Progressively higher stages correlate with neuroimaging studies of dopaminergic loss, and high correlations exist between the HY scale and some standardized scales of motor impairment, disability, and quality of life. Weaknesses include the scale's mixing of impairment and disability and its non‐linearity. Because the HY scale is weighted heavily toward postural instability as the primary index of disease severity, it does not capture completely impairments or disability from other motor features of PD and gives no information on nonmotor problems. Direct clinimetric testing of the HY scale has been very limited, but the scale fulfills at least some criteria for reliability and validity, especially for the midranges of the scale (Stages 2–4). Although a “modified HY scale” that includes 0.5 increments has been adopted widely, no clinimetric data are available on this adaptation. The Task Force recommends that: (1) the HY scale be used in its original form for demographic presentation of patient groups; (2) when the HY scale is used for group description, medians and ranges should be reported and analysis of changes should use nonparametric methods; (3) in research settings, the HY scale is useful primarily for defining inclusion/exclusion criteria; (4) to retain simplicity, clinicians should “rate what you see” and therefore incorporate comorbidities when assigning a HY stage; and (5) because of the wide usage of the modified HY scale with 0.5 increments, this adaptation warrants clinimetric testing. Without such testing, however, the original five‐point scales should be maintained. © 2004 Movement Disorder Society
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DOI: 10.1002/mds.20213
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Goetz</name><affiliation><mods:affiliation>Rush University Medical Center, Chicago, IL</mods:affiliation></affiliation></author><author><name sortKey="Poewe, Werner" sort="Poewe, Werner" uniqKey="Poewe W" first="Werner" last="Poewe">Werner Poewe</name><affiliation><mods:affiliation>Innsbruck University Hospital, Innsbruck, Austria</mods:affiliation></affiliation></author><author><name sortKey="Rascol, Olivier" sort="Rascol, Olivier" uniqKey="Rascol O" first="Olivier" last="Rascol">Olivier Rascol</name><affiliation><mods:affiliation>Rascol, Laboratoire de Pharmacologie Medicale et Clinique, Toulouse, France</mods:affiliation></affiliation></author><author><name sortKey="Sampaio, Cristina" sort="Sampaio, Cristina" uniqKey="Sampaio C" first="Cristina" last="Sampaio">Cristina Sampaio</name><affiliation><mods:affiliation>University of Aberdeen, Aberdeen, United Kingdom</mods:affiliation></affiliation></author><author><name sortKey="Stebbins, Glenn T" sort="Stebbins, Glenn T" uniqKey="Stebbins G" first="Glenn T." last="Stebbins">Glenn T. 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Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2004-09">2004-09</date><biblScope unit="volume">19</biblScope><biblScope unit="issue">9</biblScope><biblScope unit="page" from="1020">1020</biblScope><biblScope unit="page" to="1028">1028</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">25C8B049203E387D2A310E570388B735CA99635E</idno><idno type="DOI">10.1002/mds.20213</idno><idno type="ArticleID">MDS20213</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Hoehn and Yahr scale</term><term>Parkinson's disease</term><term>clinimetrics</term><term>rating scales</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The Movement Disorder Society Task Force for Rating Scales for Parkinson's disease (PD) prepared a critique of the Hoehn and Yahr scale (HY). Strengths of the HY scale include its wide utilization and acceptance. Progressively higher stages correlate with neuroimaging studies of dopaminergic loss, and high correlations exist between the HY scale and some standardized scales of motor impairment, disability, and quality of life. Weaknesses include the scale's mixing of impairment and disability and its non‐linearity. Because the HY scale is weighted heavily toward postural instability as the primary index of disease severity, it does not capture completely impairments or disability from other motor features of PD and gives no information on nonmotor problems. Direct clinimetric testing of the HY scale has been very limited, but the scale fulfills at least some criteria for reliability and validity, especially for the midranges of the scale (Stages 2–4). Although a “modified HY scale” that includes 0.5 increments has been adopted widely, no clinimetric data are available on this adaptation. The Task Force recommends that: (1) the HY scale be used in its original form for demographic presentation of patient groups; (2) when the HY scale is used for group description, medians and ranges should be reported and analysis of changes should use nonparametric methods; (3) in research settings, the HY scale is useful primarily for defining inclusion/exclusion criteria; (4) to retain simplicity, clinicians should “rate what you see” and therefore incorporate comorbidities when assigning a HY stage; and (5) because of the wide usage of the modified HY scale with 0.5 increments, this adaptation warrants clinimetric testing. Without such testing, however, the original five‐point scales should be maintained. © 2004 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Christopher G. Goetz</name><affiliations><json:string>Rush University Medical Center, Chicago, IL</json:string></affiliations></json:item><json:item><name>Werner Poewe</name><affiliations><json:string>Innsbruck University Hospital, Innsbruck, Austria</json:string></affiliations></json:item><json:item><name>Olivier Rascol</name><affiliations><json:string>Rascol, Laboratoire de Pharmacologie Medicale et Clinique, Toulouse, France</json:string></affiliations></json:item><json:item><name>Cristina Sampaio</name><affiliations><json:string>University of Aberdeen, Aberdeen, United Kingdom</json:string></affiliations></json:item><json:item><name>Glenn T. Stebbins</name><affiliations><json:string>Rush University Medical Center, Chicago, IL</json:string></affiliations></json:item><json:item><name>Carl Counsell</name><affiliations><json:string>Hospital de Santa Maria, Lisbon, Portugal</json:string></affiliations></json:item><json:item><name>Nir Giladi</name><affiliations><json:string>Tel Aviv Sourasky Medical Center, Tel‐Aviv, Israel</json:string></affiliations></json:item><json:item><name>Robert G. Holloway</name><affiliations><json:string>University of Rochester Medical Center, Rochester, NY</json:string></affiliations></json:item><json:item><name>Charity G. Moore</name><affiliations><json:string>University of South Carolina, Columbia, SC</json:string></affiliations></json:item><json:item><name>Gregor K. Wenning</name><affiliations><json:string>Innsbruck University Hospital, Innsbruck, Austria</json:string></affiliations></json:item><json:item><name>Melvin D. Yahr</name><affiliations><json:string>Mount Sinai Medical Center, New York, NY</json:string></affiliations></json:item><json:item><name>Lisa Seidl</name><affiliations><json:string>The Movement Disorder Society, Milwaukee, WI</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Hoehn and Yahr scale</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Parkinson's disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>rating scales</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>clinimetrics</value></json:item></subject><articleId><json:string>MDS20213</json:string></articleId><language><json:string>eng</json:string></language><abstract>The Movement Disorder Society Task Force for Rating Scales for Parkinson's disease (PD) prepared a critique of the Hoehn and Yahr scale (HY). Strengths of the HY scale include its wide utilization and acceptance. Progressively higher stages correlate with neuroimaging studies of dopaminergic loss, and high correlations exist between the HY scale and some standardized scales of motor impairment, disability, and quality of life. Weaknesses include the scale's mixing of impairment and disability and its non‐linearity. Because the HY scale is weighted heavily toward postural instability as the primary index of disease severity, it does not capture completely impairments or disability from other motor features of PD and gives no information on nonmotor problems. Direct clinimetric testing of the HY scale has been very limited, but the scale fulfills at least some criteria for reliability and validity, especially for the midranges of the scale (Stages 2–4). Although a “modified HY scale” that includes 0.5 increments has been adopted widely, no clinimetric data are available on this adaptation. The Task Force recommends that: (1) the HY scale be used in its original form for demographic presentation of patient groups; (2) when the HY scale is used for group description, medians and ranges should be reported and analysis of changes should use nonparametric methods; (3) in research settings, the HY scale is useful primarily for defining inclusion/exclusion criteria; (4) to retain simplicity, clinicians should “rate what you see” and therefore incorporate comorbidities when assigning a HY stage; and (5) because of the wide usage of the modified HY scale with 0.5 increments, this adaptation warrants clinimetric testing. Without such testing, however, the original five‐point scales should be maintained. © 2004 Movement Disorder Society</abstract><qualityIndicators><score>8</score><pdfVersion>1.3</pdfVersion><pdfPageSize>612 x 810 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>4</keywordCount><abstractCharCount>1855</abstractCharCount><pdfWordCount>6155</pdfWordCount><pdfCharCount>38595</pdfCharCount><pdfPageCount>9</pdfPageCount><abstractWordCount>281</abstractWordCount></qualityIndicators><title>Movement Disorder Society Task Force report on the Hoehn and Yahr staging scale: Status and recommendations The Movement Disorder Society Task Force on rating scales for Parkinson's disease</title><genre><json:string>article</json:string></genre><host><volume>19</volume><publisherId><json:string>MDS</json:string></publisherId><pages><total>9</total><last>1028</last><first>1020</first></pages><issn><json:string>0885-3185</json:string></issn><issue>9</issue><subject><json:item><value>Research Article</value></json:item></subject><genre><json:string>Journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1531-8257</json:string></eissn><title>Movement Disorders</title><doi><json:string>10.1002/(ISSN)1531-8257</json:string></doi></host><publicationDate>2004</publicationDate><copyrightDate>2004</copyrightDate><doi><json:string>10.1002/mds.20213</json:string></doi><id>25C8B049203E387D2A310E570388B735CA99635E</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/25C8B049203E387D2A310E570388B735CA99635E/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/25C8B049203E387D2A310E570388B735CA99635E/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/25C8B049203E387D2A310E570388B735CA99635E/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Movement Disorder Society Task Force report on the Hoehn and Yahr staging scale: Status and recommendations The Movement Disorder Society Task Force on rating scales for Parkinson's disease</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><availability><p>WILEY</p></availability><date>2004</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Movement Disorder Society Task Force report on the Hoehn and Yahr staging scale: Status and recommendations The Movement Disorder Society Task Force on rating scales for Parkinson's disease</title><author><persName><forename type="first">Christopher G.</forename><surname>Goetz</surname></persName><note type="biography">Chairperson</note><note type="correspondence"><p>Correspondence: Rush University Medical Center, 1725 W. Harrison Street, Chicago, IL 60612</p></note><affiliation>Chairperson</affiliation><affiliation>Rush University Medical Center, Chicago, IL</affiliation></author><author><persName><forename type="first">Werner</forename><surname>Poewe</surname></persName><note type="biography">Writing Committee</note><affiliation>Writing Committee</affiliation><affiliation>Innsbruck University Hospital, Innsbruck, Austria</affiliation></author><author><persName><forename type="first">Olivier</forename><surname>Rascol</surname></persName><note type="biography">Writing Committee</note><affiliation>Writing Committee</affiliation><affiliation>Rascol, Laboratoire de Pharmacologie Medicale et Clinique, Toulouse, France</affiliation></author><author><persName><forename type="first">Cristina</forename><surname>Sampaio</surname></persName><note type="biography">Writing Committee</note><affiliation>Writing Committee</affiliation><affiliation>University of Aberdeen, Aberdeen, United Kingdom</affiliation></author><author><persName><forename type="first">Glenn T.</forename><surname>Stebbins</surname></persName><note type="biography">Writing Committee</note><affiliation>Writing Committee</affiliation><affiliation>Rush University Medical Center, Chicago, IL</affiliation></author><author><persName><forename type="first">Carl</forename><surname>Counsell</surname></persName><note type="biography">Expert Consultant</note><affiliation>Expert Consultant</affiliation><affiliation>Hospital de Santa Maria, Lisbon, Portugal</affiliation></author><author><persName><forename type="first">Nir</forename><surname>Giladi</surname></persName><note type="biography">Expert Consultant</note><affiliation>Expert Consultant</affiliation><affiliation>Tel Aviv Sourasky Medical Center, Tel‐Aviv, Israel</affiliation></author><author><persName><forename type="first">Robert G.</forename><surname>Holloway</surname></persName><note type="biography">Expert Consultant</note><affiliation>Expert Consultant</affiliation><affiliation>University of Rochester Medical Center, Rochester, NY</affiliation></author><author><persName><forename type="first">Charity G.</forename><surname>Moore</surname></persName><note type="biography">Expert Consultant</note><affiliation>Expert Consultant</affiliation><affiliation>University of South Carolina, Columbia, SC</affiliation></author><author><persName><forename type="first">Gregor K.</forename><surname>Wenning</surname></persName><note type="biography">Expert Consultant</note><affiliation>Expert Consultant</affiliation><affiliation>Innsbruck University Hospital, Innsbruck, Austria</affiliation></author><author><persName><forename type="first">Melvin D.</forename><surname>Yahr</surname></persName><note type="biography">Deceased.</note><note type="biography">Expert Consultant</note><affiliation>Deceased.</affiliation><affiliation>Expert Consultant</affiliation><affiliation>Mount Sinai Medical Center, New York, NY</affiliation></author><author><persName><forename type="first">Lisa</forename><surname>Seidl</surname></persName><note type="biography">Movement Disorder Society Secretariat Staff</note><affiliation>Movement Disorder Society Secretariat Staff</affiliation><affiliation>The Movement Disorder Society, Milwaukee, WI</affiliation></author></analytic><monogr><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="pISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><idno type="DOI">10.1002/(ISSN)1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2004-09"></date><biblScope unit="volume">19</biblScope><biblScope unit="issue">9</biblScope><biblScope unit="page" from="1020">1020</biblScope><biblScope unit="page" to="1028">1028</biblScope></imprint></monogr><idno type="istex">25C8B049203E387D2A310E570388B735CA99635E</idno><idno type="DOI">10.1002/mds.20213</idno><idno type="ArticleID">MDS20213</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2004</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>The Movement Disorder Society Task Force for Rating Scales for Parkinson's disease (PD) prepared a critique of the Hoehn and Yahr scale (HY). Strengths of the HY scale include its wide utilization and acceptance. Progressively higher stages correlate with neuroimaging studies of dopaminergic loss, and high correlations exist between the HY scale and some standardized scales of motor impairment, disability, and quality of life. Weaknesses include the scale's mixing of impairment and disability and its non‐linearity. Because the HY scale is weighted heavily toward postural instability as the primary index of disease severity, it does not capture completely impairments or disability from other motor features of PD and gives no information on nonmotor problems. Direct clinimetric testing of the HY scale has been very limited, but the scale fulfills at least some criteria for reliability and validity, especially for the midranges of the scale (Stages 2–4). Although a “modified HY scale” that includes 0.5 increments has been adopted widely, no clinimetric data are available on this adaptation. The Task Force recommends that: (1) the HY scale be used in its original form for demographic presentation of patient groups; (2) when the HY scale is used for group description, medians and ranges should be reported and analysis of changes should use nonparametric methods; (3) in research settings, the HY scale is useful primarily for defining inclusion/exclusion criteria; (4) to retain simplicity, clinicians should “rate what you see” and therefore incorporate comorbidities when assigning a HY stage; and (5) because of the wide usage of the modified HY scale with 0.5 increments, this adaptation warrants clinimetric testing. Without such testing, however, the original five‐point scales should be maintained. © 2004 Movement Disorder Society</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>Hoehn and Yahr scale</term></item><item><term>Parkinson's disease</term></item><item><term>rating scales</term></item><item><term>clinimetrics</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>article category</head><item><term>Research Article</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2004-01-20">Received</change><change when="2004-03-21">Registration</change><change when="2004-09">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/25C8B049203E387D2A310E570388B735CA99635E/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>Hoboken</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-8257</doi><issn type="print">0885-3185</issn><issn type="electronic">1531-8257</issn><idGroup><id type="product" value="MDS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="MOVEMENT DISORDERS">Movement Disorders</title><title type="short">Mov. Disord.</title></titleGroup></publicationMeta><publicationMeta level="part" position="90"><doi origin="wiley" registered="yes">10.1002/mds.v19:9</doi><numberingGroup><numbering type="journalVolume" number="19">19</numbering><numbering type="journalIssue">9</numbering></numberingGroup><coverDate startDate="2004-09">September 2004</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="40" status="forIssue"><doi origin="wiley" registered="yes">10.1002/mds.20213</doi><idGroup><id type="unit" value="MDS20213"></id></idGroup><countGroup><count type="pageTotal" number="9"></count></countGroup><titleGroup><title type="articleCategory">Research Article</title><title type="tocHeading1">Research Articles</title></titleGroup><copyright ownership="thirdParty">Copyright © 2004 Movement Disorder Society</copyright><eventGroup><event type="manuscriptReceived" date="2004-01-20"></event><event type="manuscriptRevised" date="2004-03-18"></event><event type="manuscriptAccepted" date="2004-03-21"></event><event type="firstOnline" date="2004-06-16"></event><event type="publishedOnlineFinalForm" date="2004-08-30"></event><event type="publishedOnlineAcceptedOrEarlyUnpaginated" date="2004-06-16"></event><event type="xmlConverted" agent="Converter:JWSART34_TO_WML3G version:2.3.27 mode:FullText source:FullText result:FullText" date="2010-11-22"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-02-02"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-31"></event></eventGroup><numberingGroup><numbering type="pageFirst">1020</numbering><numbering type="pageLast">1028</numbering></numberingGroup><correspondenceTo>Rush University Medical Center, 1725 W. Harrison Street, Chicago, IL 60612</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:MDS.MDS20213.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="1"></count><count type="tableTotal" number="1"></count><count type="referenceTotal" number="49"></count><count type="wordTotal" number="6753"></count></countGroup><titleGroup><title type="main" xml:lang="en"><i>Movement</i> Disorder Society Task Force report on the Hoehn and Yahr staging scale: Status and recommendations The <i>Movement</i> Disorder Society Task Force on rating scales for Parkinson's disease</title><title type="short" xml:lang="en">The HY Staging Scale: MDS Task Force Report</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1" corresponding="yes"><personName><givenNames>Christopher G.</givenNames><familyName>Goetz</familyName></personName><jobTitle>Chairperson</jobTitle><contactDetails><email>cgoetz@rush.edu</email></contactDetails></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Werner</givenNames><familyName>Poewe</familyName></personName><jobTitle>Writing Committee</jobTitle></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af3"><personName><givenNames>Olivier</givenNames><familyName>Rascol</familyName></personName><jobTitle>Writing Committee</jobTitle></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af6"><personName><givenNames>Cristina</givenNames><familyName>Sampaio</familyName></personName><jobTitle>Writing Committee</jobTitle></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af5"><personName><givenNames>Glenn T.</givenNames><familyName>Stebbins</familyName></personName><jobTitle>Writing Committee</jobTitle></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af4"><personName><givenNames>Carl</givenNames><familyName>Counsell</familyName></personName><jobTitle>Expert Consultant</jobTitle></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af7"><personName><givenNames>Nir</givenNames><familyName>Giladi</familyName></personName><jobTitle>Expert Consultant</jobTitle></creator><creator xml:id="au8" creatorRole="author" affiliationRef="#af8"><personName><givenNames>Robert G.</givenNames><familyName>Holloway</familyName></personName><jobTitle>Expert Consultant</jobTitle></creator><creator xml:id="au9" creatorRole="author" affiliationRef="#af9"><personName><givenNames>Charity G.</givenNames><familyName>Moore</familyName></personName><jobTitle>Expert Consultant</jobTitle></creator><creator xml:id="au10" creatorRole="author" affiliationRef="#af10"><personName><givenNames>Gregor K.</givenNames><familyName>Wenning</familyName></personName><jobTitle>Expert Consultant</jobTitle></creator><creator xml:id="au11" creatorRole="author" affiliationRef="#af11" noteRef="#fn1"><personName><givenNames>Melvin D.</givenNames><familyName>Yahr</familyName></personName><jobTitle>Expert Consultant</jobTitle></creator><creator xml:id="au12" creatorRole="author" affiliationRef="#af12"><personName><givenNames>Lisa</givenNames><familyName>Seidl</familyName></personName><jobTitle>Movement Disorder Society Secretariat Staff</jobTitle></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="US" type="organization"><unparsedAffiliation>Rush University Medical Center, Chicago, IL</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="AT" type="organization"><unparsedAffiliation>Innsbruck University Hospital, Innsbruck, Austria</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="FR" type="organization"><unparsedAffiliation>Rascol, Laboratoire de Pharmacologie Medicale et Clinique, Toulouse, France</unparsedAffiliation></affiliation><affiliation xml:id="af4" countryCode="PT" type="organization"><unparsedAffiliation>Hospital de Santa Maria, Lisbon, Portugal</unparsedAffiliation></affiliation><affiliation xml:id="af5" countryCode="US" type="organization"><unparsedAffiliation>Rush University Medical Center, Chicago, IL</unparsedAffiliation></affiliation><affiliation xml:id="af6" countryCode="GB" type="organization"><unparsedAffiliation>University of Aberdeen, Aberdeen, United Kingdom</unparsedAffiliation></affiliation><affiliation xml:id="af7" countryCode="IL" type="organization"><unparsedAffiliation>Tel Aviv Sourasky Medical Center, Tel‐Aviv, Israel</unparsedAffiliation></affiliation><affiliation xml:id="af8" countryCode="US" type="organization"><unparsedAffiliation>University of Rochester Medical Center, Rochester, NY</unparsedAffiliation></affiliation><affiliation xml:id="af9" countryCode="US" type="organization"><unparsedAffiliation>University of South Carolina, Columbia, SC</unparsedAffiliation></affiliation><affiliation xml:id="af10" countryCode="AT" type="organization"><unparsedAffiliation>Innsbruck University Hospital, Innsbruck, Austria</unparsedAffiliation></affiliation><affiliation xml:id="af11" countryCode="US" type="organization"><unparsedAffiliation>Mount Sinai Medical Center, New York, NY</unparsedAffiliation></affiliation><affiliation xml:id="af12" countryCode="US" type="organization"><unparsedAffiliation>The Movement Disorder Society, Milwaukee, WI</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">Hoehn and Yahr scale</keyword><keyword xml:id="kwd2">Parkinson's disease</keyword><keyword xml:id="kwd3">rating scales</keyword><keyword xml:id="kwd4">clinimetrics</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>The <i>Movement</i> Disorder Society Task Force for Rating Scales for Parkinson's disease (PD) prepared a critique of the Hoehn and Yahr scale (HY). Strengths of the HY scale include its wide utilization and acceptance. Progressively higher stages correlate with neuroimaging studies of dopaminergic loss, and high correlations exist between the HY scale and some standardized scales of motor impairment, disability, and quality of life. Weaknesses include the scale's mixing of impairment and disability and its non‐linearity. Because the HY scale is weighted heavily toward postural instability as the primary index of disease severity, it does not capture completely impairments or disability from other motor features of PD and gives no information on nonmotor problems. Direct clinimetric testing of the HY scale has been very limited, but the scale fulfills at least some criteria for reliability and validity, especially for the midranges of the scale (Stages 2–4). Although a “modified HY scale” that includes 0.5 increments has been adopted widely, no clinimetric data are available on this adaptation. The Task Force recommends that: (1) the HY scale be used in its original form for demographic presentation of patient groups; (2) when the HY scale is used for group description, medians and ranges should be reported and analysis of changes should use nonparametric methods; (3) in research settings, the HY scale is useful primarily for defining inclusion/exclusion criteria; (4) to retain simplicity, clinicians should “rate what you see” and therefore incorporate comorbidities when assigning a HY stage; and (5) because of the wide usage of the modified HY scale with 0.5 increments, this adaptation warrants clinimetric testing. Without such testing, however, the original five‐point scales should be maintained. © 2004 Movement Disorder Society</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn1"><p>Deceased.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Movement Disorder Society Task Force report on the Hoehn and Yahr staging scale: Status and recommendations The Movement Disorder Society Task Force on rating scales for Parkinson's disease</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>The HY Staging Scale: MDS Task Force Report</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Disorder Society Task Force report on the Hoehn and Yahr staging scale: Status and recommendations The</title></titleInfo><name type="personal"><namePart type="given">Christopher G.</namePart><namePart type="family">Goetz</namePart><affiliation>Rush University Medical Center, Chicago, IL</affiliation><description>Correspondence: Rush University Medical Center, 1725 W. Harrison Street, Chicago, IL 60612</description><role><roleTerm type="text">author</roleTerm></role><description>Chairperson</description></name><name type="personal"><namePart type="given">Werner</namePart><namePart type="family">Poewe</namePart><affiliation>Innsbruck University Hospital, Innsbruck, Austria</affiliation><role><roleTerm type="text">author</roleTerm></role><description>Writing Committee</description></name><name type="personal"><namePart type="given">Olivier</namePart><namePart type="family">Rascol</namePart><affiliation>Rascol, Laboratoire de Pharmacologie Medicale et Clinique, Toulouse, France</affiliation><role><roleTerm type="text">author</roleTerm></role><description>Writing Committee</description></name><name type="personal"><namePart type="given">Cristina</namePart><namePart type="family">Sampaio</namePart><affiliation>University of Aberdeen, Aberdeen, United Kingdom</affiliation><role><roleTerm type="text">author</roleTerm></role><description>Writing Committee</description></name><name type="personal"><namePart type="given">Glenn T.</namePart><namePart type="family">Stebbins</namePart><affiliation>Rush University Medical Center, Chicago, IL</affiliation><role><roleTerm type="text">author</roleTerm></role><description>Writing Committee</description></name><name type="personal"><namePart type="given">Carl</namePart><namePart type="family">Counsell</namePart><affiliation>Hospital de Santa Maria, Lisbon, Portugal</affiliation><role><roleTerm type="text">author</roleTerm></role><description>Expert Consultant</description></name><name type="personal"><namePart type="given">Nir</namePart><namePart type="family">Giladi</namePart><affiliation>Tel Aviv Sourasky Medical Center, Tel‐Aviv, Israel</affiliation><role><roleTerm type="text">author</roleTerm></role><description>Expert Consultant</description></name><name type="personal"><namePart type="given">Robert G.</namePart><namePart type="family">Holloway</namePart><affiliation>University of Rochester Medical Center, Rochester, NY</affiliation><role><roleTerm type="text">author</roleTerm></role><description>Expert Consultant</description></name><name type="personal"><namePart type="given">Charity G.</namePart><namePart type="family">Moore</namePart><affiliation>University of South Carolina, Columbia, SC</affiliation><role><roleTerm type="text">author</roleTerm></role><description>Expert Consultant</description></name><name type="personal"><namePart type="given">Gregor K.</namePart><namePart type="family">Wenning</namePart><affiliation>Innsbruck University Hospital, Innsbruck, Austria</affiliation><role><roleTerm type="text">author</roleTerm></role><description>Expert Consultant</description></name><name type="personal"><namePart type="given">Melvin D.</namePart><namePart type="family">Yahr</namePart><affiliation>Mount Sinai Medical Center, New York, NY</affiliation><description>Deceased.</description><role><roleTerm type="text">author</roleTerm></role><description>Expert Consultant</description></name><name type="personal"><namePart type="given">Lisa</namePart><namePart type="family">Seidl</namePart><affiliation>The Movement Disorder Society, Milwaukee, WI</affiliation><role><roleTerm type="text">author</roleTerm></role><description>Movement Disorder Society Secretariat Staff</description></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2004-09</dateIssued><dateCaptured encoding="w3cdtf">2004-01-20</dateCaptured><dateValid encoding="w3cdtf">2004-03-21</dateValid><copyrightDate encoding="w3cdtf">2004</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">1</extent><extent unit="tables">1</extent><extent unit="references">49</extent><extent unit="words">6753</extent></physicalDescription><abstract lang="en">The Movement Disorder Society Task Force for Rating Scales for Parkinson's disease (PD) prepared a critique of the Hoehn and Yahr scale (HY). Strengths of the HY scale include its wide utilization and acceptance. Progressively higher stages correlate with neuroimaging studies of dopaminergic loss, and high correlations exist between the HY scale and some standardized scales of motor impairment, disability, and quality of life. Weaknesses include the scale's mixing of impairment and disability and its non‐linearity. Because the HY scale is weighted heavily toward postural instability as the primary index of disease severity, it does not capture completely impairments or disability from other motor features of PD and gives no information on nonmotor problems. Direct clinimetric testing of the HY scale has been very limited, but the scale fulfills at least some criteria for reliability and validity, especially for the midranges of the scale (Stages 2–4). Although a “modified HY scale” that includes 0.5 increments has been adopted widely, no clinimetric data are available on this adaptation. The Task Force recommends that: (1) the HY scale be used in its original form for demographic presentation of patient groups; (2) when the HY scale is used for group description, medians and ranges should be reported and analysis of changes should use nonparametric methods; (3) in research settings, the HY scale is useful primarily for defining inclusion/exclusion criteria; (4) to retain simplicity, clinicians should “rate what you see” and therefore incorporate comorbidities when assigning a HY stage; and (5) because of the wide usage of the modified HY scale with 0.5 increments, this adaptation warrants clinimetric testing. Without such testing, however, the original five‐point scales should be maintained. © 2004 Movement Disorder Society</abstract><subject lang="en"><genre>Keywords</genre><topic>Hoehn and Yahr scale</topic><topic>Parkinson's disease</topic><topic>rating scales</topic><topic>clinimetrics</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title></titleInfo><titleInfo type="abbreviated"><title>Mov. 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