RELIABILITY OF THE COLUMBIA SCALE FOR ASSESSING SIGNS OF PARKINSONS-DISEASE

Inter- and intrarater reliability in scoring the signs of Parkinson's disease using the original Columbia scale and a modified version of th is, the Sydney scale, were assessed in five neurologists participating in a long-term study of Parkinson's disease. Scoring was done on vide o recordings of 41 patients whose disability ranged from mild to sever e. Although all the neurologists were familiar with the scales and had received training designed to produce uniformity of scoring, interrat er reliability was poor. The mean score for the Columbia scale varied from 18.6 to 30 and for the Sydney scale from 15.2 to 23.2. By contras t, intrarater reliability was good. This study highlights the limitati ons of clinical rating scales in Parkinson's disease when more than on e rater is used. In designing clinical trials, every effort should be made to ensure that the same patient is always assessed by the same ra ter.