Objective: To evaluate the validity and reliability of MANAGE-PD tool.

Background: Timely identification of advancing symptoms in patients with Parkinson’s Disease (PD), thereby improving opportunities for medication optimization as well as device-aided therapies are areas for clinical practice improvement. MANAGE-PD is a simple clinician-reported screening tool developed to address this practice gap.

Method: The tool was developed using a mixed-method approach1 and building on a consensus of indicators identified by movement disorder specialists (MDS) Delphi-panel.2   Validity and reliability of the tool was assessed using a 2-step vignette-based approach. First step included a mix of open and closed ended questions to a panel of selected international MDSs from 15 countries (n=19). The second step included a closed ended survey of an internet-based panel of general neurologists (GN) from US and UK (n=500). A steering committee developed hypothetical vignettes (n=10) representing a wide spectrum of disease severity and categorized the outcomes as (i) adequately controlled on oral therapy; (ii) inadequately controlled on oral therapy and consider oral optimization only; (iii) inadequately controlled on oral therapy and consider evaluation for device-aided therapies along with oral optimization. In both rounds of the survey, each participant rated 4 vignettes based on a random block assignment and 1 anchor vignette. Concordance between clinical judgment for patient management versus MANAGE-PD recommendation was assessed.

Results: The MDSs panelists in the first step of validation had extensive experience in treating PD [Mean number of years (SD): 24.4 (7.6); Mean number of patients treated/month (SD): 73.2(45.4)]. Item language and vignette wording was found to be acceptable. A high concordance between clinical judgment and MANAGE-PD outcomes was observed (Intra-class co-efficient: 0.82; weighted kappa statistic:0.71; unweighted kappa statistic: 0.78; concordance for the categories ranged from 82.35-88.24%).The data collection from the survey of GNs is ongoing and will be presented.

Conclusion: Based on initial data, MANAGE-PD demonstrated high reliability and validity. Future steps include optimizing scoring algorithm based on patient-level data.

References: 1. Antonini A, Schmidt P, Odin P, Kleinman L, Skalicky A, Sail K, Jalundhwala YJ, Zamudio J, Onuk K, Marshall T, Fernandez HH. Development of a Clinician-reported Screening Tool to Identify Patients with Parkinson’s disease inadequately controlled on oral medications [abstract]. Mov Disord. 2017; 32 (suppl 2). 2. Antonini A, Stoessl AJ, Kleinman LS, Skalicky AM, Marshall TS, Sail KR, Onuk K, Odin P. (2018) Developing consensus among movement disorder specialists on clinical indicators for identification and management of advanced Parkinson’s disease: a multi-country Delphi-panel approach, Current Medical Research and Opinion, 34:12, 2063- 2073.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/assessing-the-validity-and-reliability-of-manage-pd-tool-to-identify-patients-with-parkinsons-disease-inadequately-controlled-on-oral-medications-results-from-an-international-survey-of-ge/