EDSS is not responsive as an outcome measure

How long will the EDSS survive? #MSBlog #MSResearch

“This study confirms that the EDSS is not an ideal scale and that it is not responsive enough to change. This is why we are working on several other outcome measure projects to improve on the EDSS.”

Epub: Rabadi & Vincent. Comparison of the Kurtkze Expanded Disability Status Scale and the Functional Independence Measure: measures of multiple sclerosis-related disability. Disabil Rehabil. 2013 Apr 19.

Background: MS is a disease which has a variable clinical presentation followed by a variable clinical course. Therefore, accuracy of clinical rating scales to measure disability at initial clinical presentation and during follow-up visits is essential to accurately capture the variability inherent in this disease. This is particularly vital when attempting to identify the efficacy of interventions.

Objective: This observational study in veterans with MS compared the Kurtkze Expanded Disability Status Scale (EDSS) and the Total Functional Independence Measure (TFIM) scale as measures of MS-related disability.

Methods: They retrospectively reviewed the electronic charts of 76 veterans with MS who were regularly followed in heir VA MS clinic. 

Results: The EDSS score accurately measured MS-related impairment at initial evaluation and follow-up relative to an Impairment Index. However, the EDSS score did not change over time, compared to the TFIM suggesting reduced sensitivity of the EDSS for detecting change in MS-related disability over time.

Conclusions: This suggests TFIM scale is a more sensitive measure of MS-related disability than EDSS for use in future MS clinical trials. 

Implications for Rehabilitation: This study highlights that given the paucity of scales to which EDSS has been compared, TFIM is a valuable adjunct to EDSS in measuring MS-related disability. TFIM is able to accurately measure the severity of MS-related disability and help provide for services MSers with MS-related disability would need. TFIM is an easy to administer and a sensitive scale to measure the change in MS-related disability following interventions.

About the author

Prof G

Professor of Neurology, Barts & The London. MS & Preventive Neurology thinker, blogger, runner, vegetable gardener, husband, father, cook and wine & food lover.

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