Movement disorder society task force report on the Hoehn and Yahr staging scale: Status and recommendations
Movement disorder society task force report on the Hoehn and Yahr staging scale: Status and recommendations
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DOI：
10.1002/mds.20213
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发表时间：
2004-09-01
影响因子：
8.6
通讯作者：
Seidl, L
中科院分区：
文献类型：
--
作者：
Goetz, CG;Poewe, W;Seidl, L
运动障碍协会帕金森病（PD）评定量表工作组准备了对Hoehn和Yahr量表（HY）的评论。HY量表的优点包括其广泛的使用和接受。逐渐升高的分期与多巴胺能丧失的神经影像学研究相关，HY量表与运动障碍、残疾和生活质量的一些标准化量表之间存在高度相关性。不足之处包括该量表将损伤和残疾混合在一起，以及它的非线性。由于HY量表对姿势不稳定作为疾病严重程度的主要指标有很大的权重，因此它不能完全捕获PD其他运动特征的损伤或残疾，也不能提供非运动问题的信息。HY量表的直接临床测试非常有限，但该量表至少满足一些可靠性和有效性标准，特别是对于量表的中间范围（阶段2-4）。虽然“改良HY量表”，包括0.5增量已被广泛采用，没有临床数据可用于这种适应。工作组建议：（1）HY量表以其原始形式用于患者组的人口统计学描述;（2）当HY量表用于组描述时，应报告中位数和范围，并应使用非参数方法分析变化;（3）在研究环境中，HY量表主要用于定义入选/排除标准;（4）为了保持简单性，临床医生应该“对你所看到的进行评级”，因此在分配HY分期时将合并症纳入其中;（5）由于广泛使用增量为0.5的改良HY量表，这种适应性调整保证了临床测试。但是，如果不进行这种测试，则应维持原来的五点制。(C)2004年，《运动障碍协会》。
The Movement Disorder Society Task Force for Rating Scales for Parkinson's disease (PD) prepared a critique of the Hoehn and Yahr scale (HY). Strengths of the HY scale include its wide utilization and acceptance. Progressively higher stages correlate with neuroimaging studies of dopaminergic loss, and high correlations exist between the HY scale and some standardized scales of motor impairment, disability, and quality of life. Weaknesses include the scale's mixing of impairment and disability and its non-linearity. Because the HY scale is weighted heavily toward postural instability as the primary index of disease severity, it does not capture completely impairments or disability from other motor features of PD and gives no information on nonmotor problems. Direct clinimetric testing of the HY scale has been very limited, but the scale fulfills at least some criteria for reliability and validity, especially for the midranges of the scale (Stages 2-4). Although a "modified HY scale" that includes 0.5 increments has been adopted widely, no clinimetric data are available on this adaptation. The Task Force recommends that: (1) the HY scale be used in its original form for demographic presentation of patient groups; (2) when the HY scale is used for group description, medians and ranges should be reported and analysis of changes should use nonparametric methods; (3) in research settings, the HY scale is useful primarily for defining inclusion/exclusion criteria; (4) to retain simplicity, clinicians should "rate what you see" and therefore incorporate comorbidities when assigning a HY stage; and (5) because of the wide usage of the modified HY scale with 0.5 increments, this adaptation warrants clinimetric testing. Without such testing, however, the original five-point scales should be maintained. (C) 2004 Movement Disorder Society.