Rating scales as outcome measures for clinical trials in neurology: problems, solutions, and recommendations

Jeremy C Hobart, Stefan J Cano, John P Zajicek, Alan J Thompson

Research output: Contribution to journalArticlepeer-review

398 Citations (Scopus)

Abstract

Have state-of-the-art clinical trials failed to deliver treatments for neurodegenerative diseases because of shortcomings in the rating scales used? This Review assesses two methodological limitations of rating scales that might help to answer this question. First, the numbers generated by most rating scales do not satisfy the criteria for rigorous measurements. Second, we do not really know which variables most rating scales measure. We use clinical examples to highlight concerns about the limitations of rating scales, examine their underlying rationales, clarify their implications, explore potential solutions, and make some recommendations for future research. We show that improvements in the scientific rigour of rating scales can improve the chances of reaching the correct conclusions about the effectiveness of treatments.

Original languageEnglish
Pages (from-to)1094-105
Number of pages12
JournalLancet Neurology
Volume6
Issue number12
DOIs
Publication statusPublished - Dec 2007

Keywords

  • Clinical Trials as Topic
  • Guidelines as Topic
  • Humans
  • Neurodegenerative Diseases
  • Outcome Assessment (Health Care)
  • Treatment Outcome

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