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Time between expanded disability status scale (EDSS) scores.

Jonathan Zurawski1, Bonnie I Glanz1, Alicia Chua2

  • 1Department of Neurology, Harvard Medical School, Boston, MA, USA; Partners Multiple Sclerosis Center, Brigham and Women's Hospital, Boston, MA, USA.

Multiple Sclerosis and Related Disorders
|February 15, 2019
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Summary
This summary is machine-generated.

The time to reach higher Expanded Disability Status Scale (EDSS) scores in multiple sclerosis (MS) varies significantly. Specific functional system scores predict future disability progression more accurately than others.

Keywords:
EpidemiologyMultiple sclerosisOutcome measures

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Area of Science:

  • Neurology
  • Clinical Research
  • Biostatistics

Background:

  • The Expanded Disability Status Scale (EDSS) is standard for measuring multiple sclerosis (MS) disability.
  • Disability accumulation measurement is challenging due to EDSS's unequal intervals.

Purpose of the Study:

  • Estimate time intervals between EDSS scores in a large MS cohort.
  • Determine how functional system scores impact EDSS transitions.

Main Methods:

  • Analysis of 31,394 clinical visits from 2054 MS patients in the CLIMB study.
  • Nonparametric maximum likelihood estimation for interval-censored data to calculate time to EDSS scores.
  • Mixed effects linear regression and Cox proportional hazards models to assess functional system score impact.

Main Results:

  • Median times to EDSS 2, 3, 4, 5, and 6 were 4.8, 15.1, 28.2, 31.2, and 32.4 years.
  • Disability accumulation was faster between EDSS 4-6 than EDSS 0-3 or EDSS 6-8.
  • Pyramidal, cerebellar, sensory, bowel/bladder, and mental scores predicted higher EDSS at lower levels; only pyramidal and bowel/bladder scores remained significant at higher EDSS.

Conclusions:

  • Significant variability exists in time between EDSS levels.
  • Specific functional system scores offer predictive value for MS disability progression.
  • Findings can refine EDSS use in clinical trials for MS outcome assessment.