Hoehn and Yahr Scale
Stages Parkinson's disease severity based on motor symptom distribution and balance impairment
- Highest activation tier
- Recommended
- How it is scored
- Scored in code; a stated value is compared only from the structured summary or a supplied value
- Scoring type
- classification
- Care settings
- Inpatient, Outpatient
When it activates
Scribeable activates a calculator from the encounter. The Hoehn and Yahr Scale can activate when the transcript or pasted chart context documents any of these:
- Parkinson's disease staging
- Parkinson's disease progression assessment
- Movement disorder evaluation
- Parkinson's treatment planning
- Disability assessment in Parkinson's
A coded diagnosis can also activate it. ICD-10 prefixes carried by the registry: G20.
Note-type scope: it activates on notes whose subject resolves to neurology, rehab, hospital medicine. A note that resolves to another subject does not carry it even when the clinician's specialty matches; a note with no resolvable subject (a generic consultation) falls back to the specialty match.
Inputs the note needs
1 input. Each is resolved from the transcript, the pasted chart context and charted labs; at this calculator’s tier a missing input is never requested, and a missing required input keeps the score out of the draft.
| Input | Type | Unit / options | Guidance |
|---|---|---|---|
| Hoehn and Yahr stage (0-5, accepts 0.5 increments for modified scale) | exam |
Scoring
0=Asymptomatic. 1=Unilateral involvement only. 1.5=Unilateral and axial involvement. 2=Bilateral without balance impairment. 2.5=Mild bilateral with recovery on pull test. 3=Mild to moderate bilateral, postural instability, physically independent. 4=Severe disability but can walk/stand unassisted. 5=Wheelchair-bound or bed-bound without assistance.
H&Y stage Hoehn and Yahr stage (0-5, accepts 0.5 increments for modified scale) (0=asymptomatic, 1=unilateral, 2=bilateral no balance impairment, 3=balance impairment physically independent, 4=severe w/ walking unassisted, 5=wheelchair/bed)
Interpretation
Stage 1-2: Early disease, minimal disability, responsive to dopaminergic therapy. Stage 2.5-3: Moderate disease, postural instability emerging. Stage 4-5: Advanced disease, significant disability, complex medication management needed.
Evidence
Sources carried in Scribeable's citation registry for this calculator; guideline version: Hoehn & Yahr 1967.
- Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortalityHoehn & Yahr 1967 · 1967 · link last verified 2026-03-28
How Scribeable handles it in the note
When an encounter activates the Hoehn and Yahr Scale (its highest tier is recommended), Scribeable does not ask you for missing inputs. The score is computed in code from whatever inputs resolve from the transcript, the pasted chart context or charted labs; a computed value is written into the draft only when every required input already resolves.
The score is computed in code from the resolved inputs, not recalled by the language model. A stated Hoehn and Yahr Scale value is compared against the computed one when the draft's structured summary carries it; a disagreement found there is flagged to the second drafting pass, which is instructed to correct the score and its interpretation, unless Scribeable has supplied the computed value to that pass, in which case the value the draft writes is checked against the supplied one and a detected difference is shown beside the note for you to adjudicate rather than silently rewritten.
Classified as a risk score: activated strictly, by a documented trigger, never by a permissive reading of the encounter.
See it activate on your own encounter
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