Parkinson Evidence Database
to Guide Effectiveness

PROCESS

The Parkinson Evidence Database to Guide Effectiveness (PDEDGE) task force was organized in 2012 and met for the first time at CSM 2013. The team included a balance of clinicians, academicians and scientists reflecting geographical, practice and research experience.

At the 2013 organization meeting, Task Force members developed Parkinson disease specific criteria to evaluate measures and to assess their utility in clinical, academic and research practice settings.

An initial survey generated a candidate list of 116 measures from which the PDEDGE task force Task Force selected 57 tests and measures representing those commonly used for the assessment of persons with Parkinson disease for further PDEDGE analysis.

The selected outcome measures were subdivided into categories for assessment based on the Hoehn and Yahr stages of disease (I through V) for Parkinson’s disease. Measures were also assessed based on International Classification of Function (ICF) categories of body structure and function, activity and participation.

The PDEDGE task force then divided into four, two-person teams and each team performed a comprehensive literature review on a subset of the refined list of candidate measures. These teams compiled descriptive and psychometric data on each measure from which a fact sheet was developed. Fact sheets developed by individual team members were initially cross-checked by the “secondary” reviewer on that sheet. Using evaluation criteria developed by the task force, the 2 person teams rated their assigned measures according to test psychometric and clinical utility standards. Following rating consensus within the 2 person review teams, measures were more broadly considered and rated by the full task force of 8 members using an on-line Delphi process. Ratings for individual measures were deliberated until 80% agreement was reached for each of the rated categories.

The PDEDEGE task force worked in close collaboration with project managers at Rehab Measures.org to facilitate the on-line dissemination of task force findings. The task force also developed recommendations in support of a core set of outcome measures representing all ICF categories that were deemed appropriate for use across multiple stages of the disease process, and across multiple settings and for multiple user groups (e.g., clinician, educator, researcher). Findings and recommendations for the use of outcome measures for assessment of those with PD were presented at CSM 2014. The PDEDGE task force summary documents and recommendations are available both on the Academy of Neurologic Physical Therapy page and at www.RehabilitationMeasures.org.

TRANSLATION

Ongoing translation efforts for the PDEDGE TF recommendations include: 1) Clinical Translation: Select Outcome measures for use in the patient population with Parkinson’s disease will be published in the Archives of Physical Medicine and Rehabilitation to maximize visibility of measures with outstanding clinical utility and test psychometrics; 2) Research Translation: The PD EDGE TF will recommend targeted research to fill gaps in knowledge related to psychometric properties of outcome measures applicable to persons with PD; and 3.) Public Translation: the TF members are putting together documents for public dissemination. This proposed effort aims to strengthen the most promising Parkinson's disease outcome measures through clinical integration and research aimed at enhancing test psychometric properties. The goal of these translational efforts is to improve clinical management, facilitate outcomes research across centers, and research utilization for select measures used to assess individuals with Parkinson's disease.

RECOMMENDATION CATEGORIES

4	Highly Recommend	excellent psychometrics in target population (e.g. valid and reliable with available data to guideinterpretation) AND excellent clinical utility (e.g. administration is < 20 minutes, requires equipment typically found in the clinic, no copyright payment required, easy to score)
3	Recommend	good- psychometrics (may lack information about reliability, validity, or available data to guide interpretation) in target population AND good clinical utility (e.g. administration/scoring > 20 minutes, may require additional equipment to purchase or construct)
2	Reasonable to use, but limited study in target group	good or excellent psychometric data demonstrated in at least one population*, but insufficient study in target population to support a stronger recommendation (does not have any negative psychometric data) good clinical utility (e.g. administration/scoring > 20 minutes, may require additional equipment to purchase or construct) No negative psychometric data.
1	Do not Recommend	poor psychometrics (inadequate reliability or validity)OR limited clinical utility (extensive testing time, unusual or expensive equipment, ongoing costs to administer, etc.)

RECOMMENDATIONS

Recommendations for use of each outcome measure reviewed were categorized according to four criteria:

Disease Stage (Hoehn & Yahr I, II, III, IV and V);
Academic: Recommendations for each outcome measure to entry level PT education were also included. Measures were characterized as those that students should learn to administer, should be exposed to, or are not recommended.
Research: Measures were categorized as being recommended or not recommended for use in research and whether there was a need for additional research for a given measure.

Click here to search for completed Rehab Measures templates of for Parkinson’s disease outcome measures reviewed. Rehab Measures templates provide additional detail characterizing comprehensive psychometric test properties, comments on clinical utility, and for a full reference list. Rehab Measures will periodically update the the published summary for each posted outcome measure in their database. These updates will occur in concert with ongoing efforts from the PDEDGE task force and other members of the degenerative disease practice community. In addition, each rehab measure summary invites feedback from the professional community.

Below are links to documents summarizing each of the PDEDGE task force recommendations which contain detailed information on the psychometric properties of the outcome measures and references.

One Page Summary of Recommendations

Clinical by Disease Severity

Entry Level Education

Research

Single Measure Detailed Ratings

Table All Measures

PARKINSON EDGE Task Force Members

Deb Kegelmeyer PT, DPT⁺, MS Chair
- The Ohio State University, School of Health and Rehabilitation Sciences, Physical Therapy Division, OH
Terry Ellis PT, PhD*
- Boston University, College of Health & Rehabilitation Sciences: Sargent; Department of Physical Therapy & Athletic Training
Alicia Esposito PT, DPT*
- New York University Langone Medical Center-The Rusk Institute
Rosemary Gallagher PT, DPT⁺ , PhD(c)
- New York Institute of Technology, School of Health Professions, Department of Physical Therapy, Old Westbury, NY
Cathy C. Harro PT, MS*
- Grand Valley State University, College of Health Professions, Department of Physical Therapy
Jeffrey Hoder PT, DPT*
- Virginia Commonwealth University, andVCU PD and Movement Disorders Center
Erin Hussey DPT, MS*
- University of Wisconsin, LaCrosse, Department of Health Professions, Physical Therapy Program
Suzanne Oneal , PT, DPT*
- Shea Scottsdale Healthcare, Outpatient Therapy Department