Sage Journals: Discover world-class research

Abstract

Background:

The Expanded Disability Status Scale (EDSS) is the standard measure of disability in multiple sclerosis clinical trials. The EDSS has limited application in the clinical setting due to required completion time and scoring complexity. Systematically recording an objective, simplified, less time-intensive, and neurologist-derived disability score would be beneficial for patient care.

Objective:

To develop and validate a streamlined version of the Expanded Disability Status Scale (sEDSS) for clinical monitoring.

Methods:

The EDSS was modified by eliminating maneuvers with no impact on function, consolidating redundancies, and simplifying scoring. This sEDSS was refined and preliminarily validated using a pilot cohort of 102 patients. Subsequently, the sEDSS was retrospectively validated using 968 patients from the CombiRx trial. We evaluated correlation and agreement between each functional system as well as the overall sEDSS and EDSS.

Results:

The sEDSS correlated strongly with the EDSS, both overall (Spearman’s rho = 0.93) and for each functional system (Spearman’s rho 0.65–0.97). Correlation was slightly lower for functional systems where scoring was modified for consolidation and simplification.

Conclusion:

The sEDSS had strong agreement and correlation with the existing EDSS and can provide a useful measure of disability in clinical practice.

Keywords

Multiple sclerosis Expanded Disability Status Scale disability disability outcome measure clinical scale

Get full access to this article

View all access options for this article.

References

National Multiple Sclerosis Society. Frequently asked questions, http://www.nationalmssociety.org/What-is-MS/MS-FAQ-s (2016, accessed 8 July 2016).

Kurtzke

JF.

Rating neurologic impairment in multiple sclerosis: An expanded disability status scale (EDSS). Neurology 1983; 33: 1444–1452.

Fischer

Rudick

Cutter

. The Multiple Sclerosis Functional Composite Measure (MSFC): An integrated approach to MS clinical outcome assessment. National MS Society Clinical Outcomes Assessment Task Force. Mult Scler 1999; 5: 244–250.

Hobart

Lamping

Fitzpatrick

. The Multiple Sclerosis Impact Scale (MSIS-29): A new patient-based outcome measure. Brain 2001; 124: 962–973.

Hohol

Orav

Weiner

HL.

Disease steps in multiple sclerosis: A simple approach to evaluate disease progression. Neurology 1995; 45: 251–255.

Kappos

Neurostatus (version 04/10.2), 2011. University Hospital Basel, Switzerland, https://www.neurostatus.net/

Kappos

D’Souza

Lechner-Scott

. On the origin of Neurostatus. Mult Scler Relat Disord 2015; 4: 182–185.

Meyer-Moock

Feng

Maeurer

. Systematic literature review and validity evaluation of the Expanded Disability Status Scale (EDSS) and the Multiple Sclerosis Functional Composite (MSFC) in patients with multiple sclerosis. BMC Neurol 2014; 14: 58.

Amato

Ponziani

Quantification of impairment in MS: Discussion of the scales in use. Mult Scler 1999; 5: 216–219.

10.

Rae-Grant

Bennett

Sanders

. Quality improvement in neurology: Multiple sclerosis quality measures: Executive summary. Neurology 2015; 85: 1904–1908.

11.

Hobart

Freeman

Thompson

Kurtzke scales revisited: The application of psychometric methods to clinical intuition. Brain 2000; 123(Pt 5): 1027–1040.

12.

Lindsey

Scott

Lynch

. The CombiRx trial of combined therapy with interferon and glatiramer acetate in relapsing remitting MS: Design and baseline characteristics. Mult Scler Relat Disord 2012; 1: 81–86.

13.

Bland

Altman

DG.

Measuring agreement in method comparison studies. Stat Methods Med Res 1999; 8: 135–160.

14.

Martina

van Koningsveld

Schmitz

. Measuring vibration threshold with a graduated tuning fork in normal aging and in patients with polyneuropathy. J Neurol Neurosurg Psychiatr 1998; 65: 743–747.

15.

Bowen

Gibbons

Gianas

. Self-administered Expanded Disability Status Scale with functional system scores correlates well with a physician-administered test. Mult Scler 2001; 7: 201–206.

16.

Collins

Ivry

Bowen

. A comparative analysis of Patient-Reported Expanded Disability Status Scale tools. Mult Scler 2016; 22: 1349–1358.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.28 MB

0.21 MB

Streamlined EDSS for use in multiple sclerosis clinical practice: Development and cross-sectional comparison to EDSS