Multiple Sclerosis, December 2001,
vol. 7, no. 6, pp. 405-410(6)
Background:
Although the Expanded Disability
Status Scale (EDSS) remains a widely used scale for evaluating impairments
in people with multiple sclerosis (MS), EDSS assessments are infeasible
in certain situations. A self-administered version of the EDSS would be
potentially useful if it yielded similar results as the conventional physician-based
version.
Methods:
We developed a self-administered
patient questionnaire to obtain ratings of neurologic impairments, and
developed algorithms to estimate EDSS scores. We mailed the questionnaires
to all new consecutive patients scheduled to be seen at an MS clinic. Questionnaires
were completed prior to the visit, and traditional EDSS ratings were made
by one of two neurologists at the visit. One hundred and forty-six pairs
of patient questionnaires and physician EDSS assessments were obtained.
Results:
Kappa values for agreement between
the physician's EDSS scores and the questionnaire-derived scores were 0.13
(for exact agreement), 0.39 (±0.5 EDSS steps), and 0.56 (±1.0
EDSS steps). A scatterplot showed that agreement was best at EDSS scores
<3.0 and >5.0. Better agreement was obtained when patients had a higher
level of education, and when the physician was more certain of the diagnosis
of MS.
Conclusions:
While the self-assessed EDSS scores
do not agree highly enough to take the place of conventional EDSS scores,
they may be sufficient for MS trial screening or for assessing outcomes
across broad categories of disability.
© 2002 ingenta
Cheng E.M. [1] *; Hays R.D. [3];
Myers L.W. [1]; Ellison G.W. [1]; Beckstrand M. [1]; Vickrey B.G. [3]
[1] Department of Neurology, UCLA,
Los Angeles, California, USA [3] RAND, Santa Monica, California, USA [*]
Correspondence: EM Cheng, UCLA, 650 Charles Young Drive South, B-537 Factor
Building, Box 951736, Los Angeles, CA 90095-1769, USA
Abstract: