Self-Assessment of Neurologic Impairment in Multiple Sclerosis

The Kurtzke Expanded Disability Status Scale (EDSS) is the standard method for eval uating neurologic impairment in multiple sclerosis. It involves a neurologic exam and ambulation assessment performed by a physician. This study developed and tested a self-assessed EDSS in which MS patients evaluated their own level of disability and selected an overall score akin to that used by the physician. The questionnaire was administered to 50 patients who were independently assessed by a neurologist at a regular clinic visit. Results indicated a high degree of correlation with an average dis crepancy of .55 of a point with 52 percent perfect agreement and 84 percent agree ment within one point. The intraclass correlation was .90. A difference in the dis crepancy was found between low and high EDSS scores. Scores between 0 and 3.5 had an average discrepancy of 1.59, whereas scores in the range from 4.0 to 9.5 had a discrepancy of .26. Thus, although a high degree of agreement was noted overall, agreement was better in the more neurologically impaired range. Key Words: Kurtzke EDSS—Multiple sclerosis—Neurologic impairment—Self-assessment.