Clinical Outcome Assessments in Parkinson's Disease: A Scoping Review of Current Rating Scales and Future Needs
Bibliographic record
Abstract
BACKGROUND: Clinical outcome assessments (COAs) are essential for evaluating symptom severity, treatment response, and disease progression in Parkinson's disease (PD). As clinical knowledge evolves, it is necessary to revisit the recommendation status on the COAs to ensure their continued relevance and validity. OBJECTIVES: To provide an updated overview of existing MDS-recommended COAs in PD and to identify specific constructs requiring revision or further validation to inform current clinical practice and research. METHODS: The Scientific Evaluation Committee of the Movement Disorder Society COA program commissioned a position paper on the current state of COAs' recommendations. A panel of experts conducted a two-step review: first, extracting data from previous MDS publications of rating scales on COAs appraisals using a standardized template; second, conducting a scoping review up to April 2025 to identify new COAs or updated validation data on motor and non-motor constructs in PD. All study designs were considered. RESULTS: Of the 19 PD constructs identified, anxiety, apathy, anhedonia, dysautonomia, and pain had significant developments, including new COA development and further validation, making them priorities for revision. Recent reviews show that constructs like medication adherence and psychosis were sufficiently addressed. CONCLUSIONS: This review identifies key symptom areas where COA critique and recommendations need to be updated to reflect advances in the field and improve assessment accuracy in clinical and research settings.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.008 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.002 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".