{"doi":"10.1002/mds.29420","title":"A Unified Framework for Evidence‐Based Diagnostic Criteria Programs in Movement Disorders","abstract":"The establishment of a diagnosis or definition of an illness1 is central to medicine. Diagnostic criteria correspond to the set of symptoms, signs, and tests that identify individuals with a disease in clinical research and/or clinical practice. Studies adopting validated diagnostic criteria generate knowledge about pathophysiology, prognosis, and therapeutic development. Diagnostic criteria must incorporate the heterogeneity of a disease to identify as many affected individuals as possible and, well anchored in the tradition of Jean-Martin Charcot, must include the archetype, as well as variants and cases of partial expression (formes frustes).2 The development and validation of diagnostic criteria with high accuracy are timely in our field and require both rigor and flexibility. One major challenge is the opposing tension between research and clinical practice, because a clinical practice definition requires widely available diagnostic items, whereas research allows incorporation of innovative, though less accessible, methods with high diagnostic value, which nevertheless must be independently established. The International Parkinson and Movement Disorders Society (MDS) has sponsored projects for developing diagnostic criteria for movement disorders, including several forms of parkinsonism.3-5 Although these high-profile programs have society sponsorship, each has worked under its own autonomy without a centralized framework. In this Viewpoint, we present a proposal of a framework designed to be a uniform, but still flexible, method to develop, validate, and operationalize diagnostic criteria in movement disorders. We start by providing a summary overview of prior projects related to parkinsonism, but the principles will apply to other diagnostic criteria programs with the MDS. Importantly, however, we focus on diagnostic criteria and not on programs related to disease-staging or clinical classification schemes, although some principles and concepts may apply. Neurodegenerative parkinsonisms are the movement disorders with more diagnostic criteria published in recent years, namely Parkinson's disease (PD), multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and dementia with Lewy bodies (DLB). In 2014, a position paper on PD diagnostic criteria highlighted the need for new diagnostic criteria.6 Themes emphasized as requiring revision were the use of neuropathology as a gold standard, the expert clinical examination as the benchmark for diagnostic criteria, descriptive limits of the clinical heterogeneity of PD, and the justification of an identifiable prodromal phase.6 As a result, the MDS Clinical Diagnostic Criteria for PD3 and the MDS Research Criteria for Prodromal PD risk7 were completed, followed by the MDS Criteria for Clinically Established Early PD.8 The MDS-PSP criteria4 and the recently published MDS-MSA criteria5 are examples of other MDS-supported diagnostic criteria projects in other forms of neurodegenerative parkinsonism. In parallel, the DLB Consortium elaborated the revised criteria for DLB9 and prodromal DLB.10 On the surface, these diagnostic criteria programs adopted similar processes such as an initial literature review and a consensus methodology for the generation of a list of diagnostic items that served as the basis for the development of specific diagnostic criteria. However, there was significant methodological heterogeneity across these different diagnostic criteria projects (Tables S1 and S2), so that direct harmonization of approaches is not possible. The successes of these programs with the lack of a uniform diagnostic strategy prompt us to consider the opportunity for a standardized data-driven process for development and reporting of diagnostic criteria in movement disorders. Inspired by the meritorious work developed so far on diagnostic criteria for movement disorders and encouraged by the availability of new methodologies and statistical models, for future diagnostic crit","journal":"Movement Disorders","year":2023,"id":363903,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":7,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9563,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1044334,"name":"Margherita Fabbri","orcid":"0000-0001-7250-592X","position":1,"is_corresponding":false},{"id":351823,"name":"Sheng Luo","orcid":"0000-0003-4214-5809","position":2,"is_corresponding":false},{"id":92181,"name":"Glenn T. Stebbins","orcid":"0000-0001-7905-9336","position":3,"is_corresponding":false},{"id":92178,"name":"Christopher G. Goetz","orcid":"0000-0003-1665-8205","position":4,"is_corresponding":false},{"id":92185,"name":"Cristina Sampaio","orcid":"0000-0002-7052-9079","position":5,"is_corresponding":false},{"id":523733,"name":"Tiago Mestre","orcid":"0000-0002-6973-7479","position":0,"is_corresponding":true}],"reference_count":25,"raw_metadata":null,"created_at":"2026-07-19T01:14:32.510714Z","pmid":"37156735","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}