<p>Parkinson’s disease (PD) is a highly heterogeneous condition with symptoms spanning motor and non-motor domains. Clinical scales like the Movement Disorder Society’s Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) are standard in clinical trials where disease progression is monitored. They rely on summing item values, assuming uniform item importance and score increments. Here, we propose a novel data-driven approach to optimize weights for such scales–so that total scores better reflect the underlying disease severity. In a retrospective observational analysis of longitudinal cohort data from the Parkinson’s Progression Markers Initiative (PPMI), our methods identified which items (and value increments) most strongly indicate PD progression, down-weighting or excluding less informative items. The learned weights substantially improve the monotonic relationship between total scores and clinical progression. We validated our weights using both held-out PPMI data and an independent dataset (BeaT-PD), demonstrating their robustness. Applying such weights in clinical trials may increase power and reduce the required sample size<sup><CitationRef CitationID="CR1">1</CitationRef></sup>.</p>

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Optimizing Parkinson’s disease progression scales using computational methods

  • Assaf Benesh,
  • Roy N. Alcalay,
  • Anat Mirelman,
  • Ron Shamir

摘要

Parkinson’s disease (PD) is a highly heterogeneous condition with symptoms spanning motor and non-motor domains. Clinical scales like the Movement Disorder Society’s Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) are standard in clinical trials where disease progression is monitored. They rely on summing item values, assuming uniform item importance and score increments. Here, we propose a novel data-driven approach to optimize weights for such scales–so that total scores better reflect the underlying disease severity. In a retrospective observational analysis of longitudinal cohort data from the Parkinson’s Progression Markers Initiative (PPMI), our methods identified which items (and value increments) most strongly indicate PD progression, down-weighting or excluding less informative items. The learned weights substantially improve the monotonic relationship between total scores and clinical progression. We validated our weights using both held-out PPMI data and an independent dataset (BeaT-PD), demonstrating their robustness. Applying such weights in clinical trials may increase power and reduce the required sample size1.