Analysis of the Measurement Properties of the King's Parkinson's Disease Pain Scale (KPPS-Brazil) and the Activities of Daily Living Questionnaire for individuous with Parkinson Disease
Bibliographic record
Abstract
Introduction: Pain is a very prevalent and disabling symptom in Parkinson’s disease (PD). Along with this symptom, the disease's motor alterations related to other non-motor symptoms may cause it difficult to perform activities of daily living (ADL). Therefore, it is critical to assess pain using a specific tool capable of classifying the several types of pain present in PD as well as evaluating the patient's perceived ability to do ADL. Instruments with adequate measuring properties and clinical utility are required for this. Objective: To investigate the measurement properties of the King’s Parkinson’s Disease Pain Scale (KPPS-Brazil) and the Activities of Daily Living Questionnaire (ADLQ-Brazil). Methods: This methodological study investigated the test-retest reliability and construct validity of the KPPS-Brazil and the ADLQ-Brazil in people with PD in accordance with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). Fifty patients (30 men, mean age 68±9.5 years) were evaluated in two moments (test and retest), with an interval of 7 to 10 days. KPPS-Brazil and ADLQ-Brazil were applied in the test and retest, and the application of the ADLQ in the retest was carried out through telephone contact. Body structure and function components were assessed (pain: McGill Questionnaire; depressive symptoms: Beck Depression Inventory, BDI; fatigue: Modified Fatigue Impact Scale, MFIS; sleep disorders: Parkinson’s Disease Sleep Scale, PDSS; apathy: Apathy Scale and balance: MiniBESTest), activity (digital dexterity: Nine Hole Peg Test, 9- HPT; mobility: Timed Up and Go, TUG, including dual task and functional capacity: Moviment Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale , MDS-UPDRSII) and participation (quality of life: The 39 item Parkinson’s Disease Questionnaire, PDQ-39). Test-retest reliability was assessed by kappa (k) statistics for individual KPPS items and by intraclass correlation coefficient (ICC) for individual ADLQ items and total scores of both instruments. The measurement standard error (SEM) and the minimum detectable change (DMC) were also calculated and the Bland-Altman graph was analyzed for agreement analysis. For the assessment of construct validity, predefined hypotheses were created to estimate the strength of correlations between the KPPS and ADLQ scores and measures of body structure and function, activity and participation using Spearman's correlation coefficients. Results: A high level of agreement was found between the total KPPS scores obtained in both applications (ICC = 0.992; CI 95%=0.983–0.996). For the domains, 57% had very high reliability (ICC > 0.90) and 43% had high reliability (ICC > 0.75). SEM (1.09) and DMC (3,02) showed clinically acceptable values. Of the established hypotheses, 83% were confirmed, indicating adequate KPPS-Brazil construct validity. For the ADLQ, a high level of agreement was also found for the total scores (ICC = 0.997; 95% CI=0.994–0.998). Nineteen items had almost perfect agreement (k=0.81–1.0) and one of them had perfect reliability (k=1.0). SEM (2.16) and DMC (5.9) showed clinically acceptable values. Regarding the established hypotheses, 100% were confirmed, indicating adequate construct validity of the ADLQ-Brazil. Conclusions: Both the KPPS-Brazil and the ADLQ-Brazil were found to be valid and reliable for evaluating pain and ADL performance in individuals with PD, respectively.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.035 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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 source (direct Gemma or distilled Codex), 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".