Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Jun 7:8:55.
doi: 10.1186/1477-7525-8-55.

Disability status and quality of life in multiple sclerosis: non-linearity of the Expanded Disability Status Scale (EDSS)

Sabine Twork  1 , Susanne Wiesmeth, Milena Spindler, Markus Wirtz, Sabine Schipper, Dieter Pöhlau, Jörg Klewer, Joachim Kugler
Affiliations

Disability status and quality of life in multiple sclerosis: non-linearity of the Expanded Disability Status Scale (EDSS)

Sabine Twork et al. Health Qual Life Outcomes. .

Abstract

Background: Progression in disability as measured by increase in the Expanded Disability Status Scale (EDSS) is commonly used as outcome variable in clinical trials concerning multiple sclerosis (MS). In this study, we addressed the question, whether there is a linear relationship between disability status and health related quality of life (HRQOL) in MS.

Methods: 7305 MS patients were sent a questionnaire containing a German version of the "Multiple Sclerosis Quality of Life (MSQOL)-54" and an assessment of self-reported disability status analogous to the EDSS. 3157 patients participated in the study. Patients were allocated to three groups according to disability status.

Results: Regarding the physical health composite and the mental health composite as well as most MSQOL-54 subscales, the differences between EDSS 4.5-6.5 and EDSS > or = 7 were clearly smaller than the differences between EDSS < or = 4 and EDSS 4.5-6.5.

Conclusion: These results indicate a non-linear relationship between disability status and HRQOL in MS. The EDSS does not seem to be interval scaled as is commonly assumed. Consequently, absolute increase in EDSS does not seem to be a suitable outcome variable in MS studies.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Mean MSQOL-54 composite scores (adjusted for effects of age and disease duration; with standard deviations) of the three ambulation status subgroups.
Figure 2
Figure 2
Mean sexual function scores (adjusted for effects of age and disease duration; with standard deviations) of the three ambulation status subgroups for men and for women.
See this image and copyright information in PMC

References

    1. Kappos L. Placebo-controlled multicentre randomised trial of interferon [beta]-1b in treatment of secondary progressive multiple sclerosis. The Lancet. 1998;352(9139):1491–1497. doi: 10.1016/S0140-6736(98)10039-9. - DOI - PubMed
    1. Ebers GC. Randomised double-blind placebo-controlled study of interferon [beta]-1a in relapsing/remitting multiple sclerosis. The Lancet. 1998;352(9139):1498–1504. doi: 10.1016/S0140-6736(98)03334-0. - DOI - PubMed
    1. Hartung H-P, Gonsette R, Konig N, Kwiecinski H, Guseo A, Morrissey SP, Krapf H, Zwingers T. Mitoxantrone in progressive multiple sclerosis: a placebo-controlled, double-blind, randomised, multicentre trial. The Lancet. 2002;360(9350):2018–2025. doi: 10.1016/S0140-6736(02)12023-X. - DOI - PubMed
    1. Storr LK, Sorensen PS, Ravnborg M. The efficacy of multidisciplinary rehabilitation in stable multiple sclerosis patients. Multiple Sclerosis. 2006;12(2):235–242. doi: 10.1191/135248506ms1250oa. - DOI - PubMed
    1. Putzki N, Fischer J, Gottwald K, Reifschneider G, Ries S, Siever A, Hoffmann F, Käfferlein W, Kausch U, Liedtke M, Kirchmeier J, Gmünd S, Richter A, Schicklmaier P, Niemczyk G, Wernsdörfer C, Hartung HP. "Mensch im Mittelpunkt" Study Group. Quality of life in 1000 patients with early relapsing-remitting multiple sclerosis. European Journal of Neurology. 2009;16(6):713–720. doi: 10.1111/j.1468-1331.2009.02572.x. - DOI - PubMed

Publication types