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Disability rating scales in multiple sclerosis
Annals of the New York Academy of Sciences
|January 1, 1984
Summary
The International Federation of Multiple Sclerosis Societies is defining a Minimal Data Set for multiple sclerosis, focusing on neurologic signs, physical disabilities, and societal impact. The Expanded Disability Status Scale plus Functional Systems is recommended for clinical trials.
Area of Science:
- Neurology
- Public Health
Background:
- Multiple Sclerosis (MS) requires standardized assessment tools.
- The World Health Organization's tripartite scheme guides MS data set development.
- Existing scales include Disability Status Scale (DSS), Expanded DSS (EDSS) with Functional Systems (FS), Incapacity Status Scale (ISS), and Environmental Status Scale (ESS).
Purpose of the Study:
- To define a Minimal Data Set for multiple sclerosis (MS).
- To align MS assessment with the World Health Organization's tripartite scheme (neurologic signs, physical disabilities, societal impact).
Main Methods:
- Utilizing ordinal scales (0=normal, higher=greater involvement).
- Recommending EDSS + FS for neurologic signs, ISS for physical disabilities, and ESS for societal impact.
- The EDSS + FS is identified as the most suitable component for clinical trial measurements.
Main Results:
- EDSS ranges from 0-10, with subdivisions for grades 1-9.
- FS assesses various neurologic functions (pyramidal, cerebellar, brain stem, sensory, bowel/bladder, visual, cerebral).
- DSS shows good correlation with the frequency and severity of involvement across all FS.
Conclusions:
- The EDSS + FS provides a coded standard neurologic examination.
- This framework aids in consistent and reliable measurement in multiple sclerosis research and clinical practice.