UTILITY OF AN OBJECTIVE DYSKINESIA RATING-SCALE FOR PARKINSONS-DISEASE - INTERRATER AND INTRARATER RELIABILITY ASSESSMENT

Although dyskinesia is a frequent and important problem in Parkinson's disease (PD), a reliable assessment measure has not been thoroughly d eveloped and tested. We modified the Obeso dyskinesia scale to create an objective rating scale for dyskinesia assessment during activities of daily living. Thirteen physicians and 15 study coordinators involve d in a clinical trial independently reviewed videotape segments of PD patients performing three tasks: walking, putting on a coat, and lifti ng a cup to the lips for drinking. Raters evaluated the severity of wo rst dyskinesia seen, the types of all dyskinesias seen, and the type o f dyskinesia most associated with motoric disability. For all assessme nts, the total group showed statistically significant inter- and intra rater reliability. Physicians had a higher consistency than did coordi nators, but for most measures the difference was not statistically sig nificant. Physicians and coordinators found the scale easy to use and especially practical for rating dyskinesia severity and for identifyin g the most disabling dyskinesia. Dyskinesias can be assessed in clinic al trials and warrant regular documentation