Assessing disablement status in multiple sclerosis

This paper is based on a critique of selected aspects of previous experience in assessing disablement status in people suffering from multiple sclerosis. It considers the influence of purpose on the approach to assessment by contrasting clinical assessments carried out for individual care with those where it is intended to pool experience for wider application. The nature of assessment is then discussed, and technical considerations such as correlation, scoring, statistical tests, and distributional characteristics. Previous work on MS is then set alongside the approach followed in the World Health Organization's International Classification of Impairments, Disabilities, and Handicaps. A comprehensive conceptual framework is discussed, and the terminology appropriate to this area. An important challenge concerns the scope of assessments, which dimensions should be taken into account. Aspects of importance in application of the WHO scheme are also noted.