Muhittin C Akbostanci1,2, Ece Bayram2, Volkan Yilmaz1, Sefer Rzayev1, Serhat Özkan3, Ayse Bora Tokcaer4, Esen Saka5, Fatma N Durmaz Celik3, Banu Özen Barut6, Zeynep Tüfekcioglu7, Ahmet Acarer8, Hatice Balaban9, Sevda Erer10, Okan Dogu11, Seda Kibaroglu12, Nursel Aydin1, Hasmet Hanagasi7, Bülent Elibol5, Murat Emre7, Glenn T Stebbins13, Christopher G Goetz13. 1. Department of Neurology Ankara University Faculty of Medicine Ankara Turkey. 2. Department of Interdisciplinary Neurosciences Ankara University Institute of Health Sciences Ankara Turkey. 3. Department of Neurology Eskisehir Osmangazi University Faculty of Medicine Eskisehir Turkey. 4. Department of Neurology Gazi University Faculty of Medicine Ankara Turkey. 5. Department of Neurology Hacettepe University Faculty of Medicine Ankara Turkey. 6. Department of Neurology Health Sciences University Kartal Dr. Lütfi Kirdar Training and Research Hospital Istanbul Turkey. 7. Department of Neurology Istanbul University Faculty of Medicine Istanbul Turkey. 8. Department of Neurology Ege University Faculty of Medicine Izmir Turkey. 9. Department of Neurology Cumhuriyet University Faculty of Medicine Sivas Turkey. 10. Department of Neurology Uludag University Faculty of Medicine Bursa Turkey. 11. Department of Neurology Mersin University Faculty of Medicine Mersin Turkey. 12. Department of Neurology Baskent University Faculty of Medicine Ankara Turkey. 13. Department of Neurological Sciences Rush University Medical Center Chicago Illinois.
Abstract
BACKGROUND: Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and Unified Dyskinesia Rating Scale (UDysRS) were developed as standard tools to rate Parkinson's disease (PD) and drug-induced dyskinesias of PD. As these scales have become widely used, there is a need for translation to non-English languages. Here we present the standardization for the Turkish translations. METHODS: The scales were translated into Turkish and then back-translated to English. These back-translations were reviewed by the MDS team. After cognitive pretesting, movement disorder specialists from nine centers tested 352 patients for MDS-UPDRS, and 250 patients for UDysRS. Confirmatory factor analyses (CFAs) were used to determine if the factor structures for the reference standards could be confirmed in the Turkish data. The comparative fit indexes (CFIs) for the scales were required to be 0.90 or higher. Exploratory factor analyses (EFAs) were conducted to explore the underlying factor structure without the constraint of a pre-specified factor structure. RESULTS: For both scales, the CFIs were 0.94 or greater as compared to the reference standard factor structures. The factor structures were consistent with that of reference standards, although there were some differences in some areas as compared to the EFA of the reference standard dataset. This may be due to the inclusion of patients with different stages of PD and different cultural properties of raters and patients. CONCLUSIONS: These results demonstrate that the Turkish translations of MDS-UPDRS and UDysRS have adequate clinimetric properties. They are established as the official translations and can be reliably used in Turkish speaking populations.
BACKGROUND: Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and Unified Dyskinesia Rating Scale (UDysRS) were developed as standard tools to rate Parkinson's disease (PD) and drug-induced dyskinesias of PD. As these scales have become widely used, there is a need for translation to non-English languages. Here we present the standardization for the Turkish translations. METHODS: The scales were translated into Turkish and then back-translated to English. These back-translations were reviewed by the MDS team. After cognitive pretesting, movement disorder specialists from nine centers tested 352 patients for MDS-UPDRS, and 250 patients for UDysRS. Confirmatory factor analyses (CFAs) were used to determine if the factor structures for the reference standards could be confirmed in the Turkish data. The comparative fit indexes (CFIs) for the scales were required to be 0.90 or higher. Exploratory factor analyses (EFAs) were conducted to explore the underlying factor structure without the constraint of a pre-specified factor structure. RESULTS: For both scales, the CFIs were 0.94 or greater as compared to the reference standard factor structures. The factor structures were consistent with that of reference standards, although there were some differences in some areas as compared to the EFA of the reference standard dataset. This may be due to the inclusion of patients with different stages of PD and different cultural properties of raters and patients. CONCLUSIONS: These results demonstrate that the Turkish translations of MDS-UPDRS and UDysRS have adequate clinimetric properties. They are established as the official translations and can be reliably used in Turkish speaking populations.
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