Development and validation of the Unified Multiple System Atrophy Rating Scale (UMSARS)

Mov Disord. 2004 Dec;19(12):1391-402. doi: 10.1002/mds.20255.


We aimed to develop and validate a novel rating scale for multiple system atrophy (Unified Multiple System Atrophy Rating Scale-UMSARS). The scale comprises the following components: Part I, historical, 12 items; Part II, motor examination, 14 items; Part III, autonomic examination; and Part IV, global disability scale. For validation purposes, 40 MSA patients were assessed in four centers by 4 raters per center (2 senior and 2 junior raters). The raters applied the UMSARS, as well as a range of other scales, including the Unified Parkinson's Disease Rating Scale (UPDRS) and the International Cooperative Ataxia Rating Scale (ICARS). Internal consistency was high for both UMSARS-I (Crohnbach's alpha = 0.84) and UMSARS-II (Crohnbach's alpha = 0.90) sections. The interrater reliability of most of the UMSARS-I and -II items as well as of total UMSARS-I and -II subscores was substantial (k(w) = 0.6-0.8) to excellent (k(w) > 0.8). UMSARS-II correlated well with UPDRS-III and ICARS (rs > 0.8). Depending on the degree of the patient's disability, completion of the entire UMSARS took 30 to 45 minutes. Based on our findings, the UMSARS appears to be a multidimensional, reliable, and valid scale for semiquantitative clinical assessments of MSA patients.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Activities of Daily Living
  • Age of Onset
  • Autonomic Nervous System / physiopathology
  • Cerebellar Ataxia / epidemiology
  • Disability Evaluation
  • Erectile Dysfunction / epidemiology
  • Female
  • Humans
  • Hypotension, Orthostatic / epidemiology
  • Male
  • Multiple System Atrophy / diagnosis*
  • Multiple System Atrophy / epidemiology*
  • Multiple System Atrophy / physiopathology
  • Observer Variation
  • Parkinsonian Disorders / epidemiology
  • Reproducibility of Results
  • Severity of Illness Index
  • Speech Disorders / epidemiology
  • Surveys and Questionnaires*
  • Urinary Incontinence / epidemiology
  • Urinary Retention / epidemiology