MDS-UPDRS

What is a Unified Parkinson's Disease Rating Scale (MDS-UPDRS)?

Similar to the Unified Parkinson’s Disease Rating Scale (UPDRS), the Movement Disorder Society-Sponsored Parkinson’s Disease Rating Scale or MDS-UPDRS is also a rating tool a practitioner can use to measure the progression and severity of Parkinson’s disease in a patient. However, there are two major differences between the two tests. 

The first difference is that the MDS-UPDRS is a modified version developed by the MDS review task force. In this version, they address problematic sections of and shortcomings in the UPDRS, such as including nonmotor symptoms, differentiating better mild signs and symptoms of Parkinson’s, and providing clearer instructions for the patient, their caregiver, and the rater. 

The second is that the updated and modified version has included, changed, removed, and moved certain sections around. Here’s a list of the sections one can find in the MDS-UPDRS. 

• Non-Motor Aspects of Experiences of Daily Living (nM-EDL)
• Motor Aspects of Experiences of Daily Living (M-EDL)
• Motor Examination
• Motor Complications

As for the scoring, MDS-UPDRS follows the majority of the process of scoring the UPDRS. To refresh your memory, raters will give a score from 0 to 4, with 0 being the highest and 4 being the lowest. If it’s impossible to test a patient, there’s also a “UR” option or “unable to rate”.

How does this MDS-UPDRS Scale work?

Planning to use the MDS-UPDRS Scale in your practice? Read below for a step-by-step guide on how to use and download our digitally editable and printable template. 

Step One. Download the Template

Access and download our template by clicking the “Use Template” or “Download Template” in this guide or by searching “MDS-UPDRS” in Carepatron’s template library on the website or app. 

Step Two. Conduct the Test

For the sections wherein the rater has to score, the rater must follow the provided instructions per item; ask the patient the provided questions or instruct them to do certain exercises; listen to the patient (and caregiver’s) answers or observe the patient’s movement, and as a final step, tick the appropriate score depending on the matching description. Here’s a list of the corresponding sections described:

• Non-Motor Aspects of Experiences of Daily Living (nM-EDL), Part IA: Complex Behaviors
• Motor Examination
• Motor Complications

Meanwhile, in the sections where the patient has to answer on their own or with the help of their caregiver, the patient must read, understand, think hard of the answers to the questions, and tick the appropriate score depending on their responses. Here’s a list of the corresponding sections described: 

• Non-Motor Aspects of Experiences of Daily Living (nM-EDL), Part IB
• Motor Aspects of Experiences of Daily Living (M-EDL)

If you’re worried that you may not remember this step, don’t worry. The template comes complete with comprehensive instructions as well as an indication of which sections must be completed by the rater or the patient and their caregiver. 

Step Three. Total Scores and Proceed with Interpretation

When the rater and patient complete the test and have totaled the scores per section, the expert may proceed with their interpretation. 

Scoring

All sections shall be scored using the provided 0-4 rating scale. To obtain a score per item, the rater must observe the patient’s response to given instructions, or the patient (and their caregiver) must answer the questions provided. 

Certain items may also ask that you do calculations. The items are as follows: Time Spent with Dyskinesias, Time Spent in the OFF state, Functional Impact of Dyskinesias, and Painful OFF-state Dystonia.

To get the total score per section used for interpretation, simply add the item scores together. For an easier time, you may record all the scores you’ve gotten in the tables at the end of the template. 

MDS-UPDRS example (sample)

We’ve created a sample of a filled-out MDS-UPDRS template to help you picture how this tool can benefit your practice. You can view the sample here or download an offline version for future reference by clicking the “Download Example PDF” button above.

Download this (MDS-UPDRS) Example: 

When to use these MDS-UPDRS tests?

Similarly to the UPDRS, the MDS-UPDRS can be used in both clinical and research settings by practitioners and researchers focusing primarily on Parkinson’s disease. To be more specific, they may use this scale and template to:

• Provide a disease prognosis to the patient
• Monitor a patient’s response to a treatment or management plan for the signs and symptoms they’re experiencing because of Parkinson’s disease
• Evaluate if a researcher’s therapies under clinical trials are effective or not

In addition, practitioners, researchers, and even caregivers may use the scale and template to identify the aspects of the patient’s life that need further observation or intervention. 

Who is this MDS-Unified Parkinson's Disease Rating Scale PDF for?

Like the UPDRS, any practitioner or researcher focusing on and specializing in Parkinson’s disease will find a PDF copy of the MDS-Unified Parkinson’s Disease Rating Scale beneficial. Aside from them, any professional caring for patients with Parkinson’s Disease will find this template useful. 

Below is a list of who the MDS-UPDRS is specifically for:

• General Practitioners
• Geriatricians
• Neurologists
• Therapists (physio, speech, occupation, language)
• Parkinson’s Disease nurses

Although it’s mentioned that caregivers may find this template helpful, it’s important to note and remember that they may not be considered a rater and can only participate in the self-questionnaire portion of the test or when the practitioner asks for more information, the patient can’t provide. 

Benefits of these free Unified Parkinson's Disease Rating Scale MDS Templates

Comprehensive Evaluation

Compared to the UPDRS, the MDS-UPDRS is more comprehensive and includes detailed instructions on how to conduct and even score the test in the template itself. 

Establish Baselines for Comparison

This scale can also be used as a baseline once the disease has been recognized. One only has to note down the date of the diagnosis so that the document may be considered the starting point. 

Tracks Progression

To formulate an effective treatment or management plan, one has to check the prognosis and progression of a disease. With our template, one can do exactly that especially if the practitioner conducts this test often or after the patient participates in disease-modifying therapies for a certain period of time. 

Know More about Patient’s Condition

With this test being more comprehensive, since the creators have addressed the shortcomings of the UPDRS, practitioners can know more about their patient’s conditions, including the more subtle signs and symptoms that the UPDRS doesn’t consider or identify. 

Fully Digital 

A fully digital MDS-UPDRS scale template can benefit both the raters, patients, and practitioners who will use this as a resource. It saves time, money, and effort and is easily accessible and can be stored in a secure EHR such as Carepatron. 

Why use this MDS-UPDRS app?

Beyond being a guide and template source for the Movement  Parkinson’s Disease Scale (MDS-UPDRS), Carepatron gives you the means and tools to automate administrative tasks and streamline business/clinical processes so you can dedicate most of your time and effort toward patient care. 

Thinking of availing of Carepatron? Before you sign up, allow us to give you the lowdown on the leading software management platform in the healthcare industry today. 

Available as an application you can use on your desktop and iOs or Android phone, Carepatron offers a variety of features and resources available to you for free when you set up an account. Some of them are access to:

• Over 100 editable, downloadable, and printable templates in PDF form of surveys, tests, assessments, and more
• A HIPAA-compliant and secure EHR system for all your digital notes and your clients’ additional medical documents
• Multiple scheduling and telehealth software applications that are integrated right into your dashboard
• An automated payment system you can set up for your client

All these and more, only on Carepatron. Give us a try today!

Reference:

Disease, n. (2023). Table 3 Score ranges (cut-off points) for severity levels in the Parkinson’s Disease Composite Scale (PDCS) scores. Retrieved 24 April 2023, from https://www.nature.com/articles/s41531-019-0097-1/tables/3

Holden, S., Finseth, T., Sillau, S., & Berman, B. (2017). Progression of MDS-UPDRS Scores Over Five Years in De Novo Parkinson Disease from the Parkinson's Progression Markers Initiative Cohort. Movement Disorders Clinical Practice, 5(1), 47-53. doi: 10.1002/mdc3.12553