Objective: To develop and validate a culturally-sensitive guide for the remote administration of the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Part III.

Background: Virtualization of care during the COVID-19 pandemic was associated with challenges for the rating of motor severity of Parkinson’s disease (PD) using Telemedicine. The MDS-UPDRS Part III is the most commonly used rating scale in PD and has not been validated in the context of a synchronous remote administration.

Method: The MDS assembled a group of investigators to conduct a 5-center international study (sites in United States, Canada, Spain, Brazil, and Taiwan). We adopt a mixed methods approach with four phases: 1. Conceptualization of the guide and development of the 1^st English prototype using a consensus approach; 2. Iterative cognitive pretesting to determine level of comprehension, relevance and agreeability of intended content; 3. Translation/back translation to non-English languages (Brazilian Portuguese, Castilian Spanish, Traditional Chinese); 4. Prospective field testing (5 PD participants per site) to evaluate patient usability (success criteria – median System Usability Scale (SUS) score >= 68) and degree of completion of the synchronous remote motor exam (success criteria – >90% of participants).

Results: The guide was conceptualized as a visual-based tool to minimize language and cultural barriers and facilitate future dissemination across all language versions of the MDS-UPDRS part III (phase 1). An English prototype of the guide was drafted after two rounds (5 PD patient in each round) of cognitive pretesting (phase 2). After successful translation/ back translation to non-English languages (phase 3), the international field testing (phase 4) documented a median System Usability Scale (SUS) score of 75, with one site not meeting success criteria (Taiwan, median SUS score – 55.0). The remote motor exam using the MDS-UPDRS Part III was completed for all study participants.

Conclusion: The guide for in-home remote assessment of the MDS-UPDRS Part III met standards of usability and allows for a successful completion of its remote administration. Further evaluation is warranted in the development of the guide in different languages and cultural settings.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/in-home-remote-assessment-of-the-mds-updrs-part-iii-multi-cultural-development-and-validation-of-a-guide-for-patients-and-care-partners/