Reply to: "Brief Clinical Rating Scales Should Not Be Overlooked"

Gesine Respondek, Ines Piot, Günter U. Höglinger
2020 Movement Disorders  
We thank Professor Lim and colleagues for commending the Progressive Supranuclear Palsy-Clinical Deficits Scale (PSP-CDS) 1 in their letter, "Brief clinical rating scales should not be overlooked." 2 The PSP-CDS is a physician-rated scale that was recently developed by members of the Movement Disorder Society (MDS)-endorsed PSP study group to reliably assess disease severity and progression in patients with PSP, regardless of the clinical phenotype. 1 The full version of the scale (PSP-CDS 7x3
more » ... comprises seven items with three response categories each (0 = no deficit; 1 = mild deficits not affecting activities of daily living (ADL); 2 = moderate deficits requiring partial external support; 3 = severe deficits necessitating permanent external support). The abbreviated PSP-CDS 7x2 scale omits the response category for mild clinical deficits, to be used in research settings, where such items without ADL-impact are of minor importance (eg, pivotal clinical trials). Finally, the short PSP-CDS 6x2 scale omits the item "Eye movements" from PSP-CDS 7x2 because their importance for ADL is controversial. As a measure of clinical meaningful deficits that generates scores with appropriate annual sensitivity to change and a completion time of~4 minutes, 1 we suggest the PSP-CDS be applied in the context of clinical trials and in clinical routine care to monitor disease progression and to identify clinical deficits requiring medical attention. We would like to point out, however, that we do not consider the PSP-CDS as a substitute for the Progressive Supranuclear Palsy Rating Scale (PSPRS) 3 in every instance, but rather a complementary instrument. The PSPRS is a 28-item scale to assess disease severity and progression in PSP. The PSPRS proved to be a reliable measure in many PSP randomized controlled trials and observation studies, as well as in routine clinical settings. 4-6 Compared to the PSP-CDS, the PSPRS assesses a larger number of items and has slightly better sensitivity to change but is less established for PSP with variant phenotypes (other than Richardson's syndrome) and takes more than three times as long to be completed. 3 This tradeoff needs to be considered based on the situation.
doi:10.1002/mds.28273 pmid:33068467 fatcat:zpy4lsoqkfeklk2cmqucwqt5ha