China
Africa
Explore chapters and articles related to this topic
AI and Autoimmunity
Published in Louis J. Catania, AI for Immunology, 2021
Multiple sclerosis (MS): An algorithm was created that combines multiple machine-learning techniques to predict the expanded disability status scale (EDSS) score of patients with multiple sclerosis at two years solely based on age, sex, and fluid attenuated inversion recovery (FLAIR) MRI data. The algorithm combined several complementary predictors: a pure deep learning predictor based on a convolutional neural network (CNN) that learns from the images, as well as classical machine-learning predictors. The method predicted two-year clinical disability in patients with multiple sclerosis with a mean EDSS score error of 1.7. This supports the use of this model to predict EDSS score progression.27
Multiple sclerosis
Published in John M. Saxton, Exercise and Chronic Disease, 2011
Awareness of the different courses of MS is important because there is increasing evidence that they are pathologically different. Clinical and MRI data suggest that inflammation and the formation of new white matter lesions are common characteristics of RRMS, while in PPMS new inflammatory demyelinating lesions are rare and diffuse atrophy of grey and white matter and changes of the normal-appearing white matter become prominent (Lassmann et al., 2007). Disease progression is assessed using the Expanded Disability Status Score (EDSS), which is a scale from 0–10 with 0 denoting no impairments caused by the disease and 10 denoting dead caused by the disease.
Monitoring Disease Activity in Multiple Sclerosis
Published in Richard K. Burt, Alberto M. Marmont, Stem Cell Therapy for Autoimmune Disease, 2019
Other scales not described here are listed in Table 1. The most widely used impairment outcome measure is the Expanded Disability Status Scale (EDSS). Kurtzke originally developed the Disability Status Scale (DSS) in 1955.4 This scale rated impairment due to MS on a 1 to 10 point scale. Subsequently, the scale was expanded to include half point steps.5 (Table 2) The scale is actually two scales. A single item scale assesses individual functional systems including visual, brainstem, pyramidal, cerebellar, sensory, cerebral, and bowel and bladder functions from 0 to 5 or 6. (Table 3) From these subsets a single EDSS score is obtained. On the lower end of the scale (0 to 3.5), the EDSS score is based on scores from the subsets. In the range of 4.0 to 6.5, scoring is based on walking distance and/or the need for an assistive device such as a cane or walker. At 7.0 and above, patients are essentially nonambulatory and scoring is based on upper extremity and bladder function. Administration of the EDSS takes 10 to 20 minutes and is performed by a neurologist or health care professional trained to administer the exam. An advantage of the EDSS includes evaluation of all major areas of the nervous system as they apply to MS. However, it is more heavily weighted toward effects on ambulation and provides limited assessment of upper extremity function, cognitive function and fatigue. EDSS scores are bimodal, clustering at 3 to 4 and 6 to 7. It is not a linear scale, thus a change from 1 to 2 is not equal in disability as a change from 6 to 7.6 Widespread use of the scale provides familiarity among examiners. Unfortunately, interrater reliability is variable, in part, because of the definition of significant change. Correlation coefficients reach 0.96 if 1.5 EDSS points are allowed as an acceptable difference between raters.7 Other studies have reported coefficients as low as 0.32.8 Interrater variability may equal one standard deviation from the true EDSS, thus a two-step change (one point on the EDSS and 2 points on the FS) has been recommended as providing definite evidence of change.9 The EDSS is further limited in that it does not detect change over a short period of time.10 A large sample size and a 2 to 3 year study is necessary to confirm change.11 A change of 1.0 point for 3 to 6 months has been used in recent large trials as indicative of sustained progression in disease change.12-14 The EDSS is significantly correlated with the Scripps Neurologic Rating Scale.10 Change in the EDSS and Ambulation Index is significantly correlated.15
The Preference-Based Multiple Sclerosis Index: an assessment of its psychometric properties and translation into Turkish
Published in Disability and Rehabilitation, 2023
Turhan Kahraman, Asiye Tuba Ozdogar, Zuhal Abasiyanik, Ozge Sagici, Cavid Baba, Ozge Ertekin, Serkan Ozakbas
Neurological disability was determined using the EDSS, a widely used scale to evaluate and follow-up neurological examinations of people with MS [17,18]. The EDSS scoring is based on the individual’s neurological examination and ambulation status. The possible range for the scale is from 0 (normal neurological examination) to 10 (death due to MS). Neurological examinations of each participant were conducted by the same senior neurologist (senior author of this study) who has a certification for a standardized, quantified neurological examination and assessment of EDSS in people with MS and has been working with people with MS since 1999. In our clinic, all neurological examination findings and EDSS scores are recorded to the MSBase (International Neuro-Immunology Registry) via iMed software.
Factors that influence quality of life in patients with multiple sclerosis in Saudi Arabia
Published in Disability and Rehabilitation, 2022
Fuad A. Abdulla, Faisal M. Albagmi, Fahd A. Al-Khamis
Patients with lower levels of disability as measured by EDSS showed a better QOL scores. However, EDSS showed weak correlations with the three measured components of QOL with the highest correlation with the physical composite. This finding is in good agreement with previous reports [20]. Further, EDSS was not one of the predictors of QOL. In the view that EDSS does not measure important aspects of the MS as a disease such as fatigue and pain, this finding was expected. Quality of life reflect the patients’ perception about their condition (i.e., an inner view) while EDSS is an evaluation done by a health care provider who mainly looks at the patient condition from outside. Additionally, EDSS does not seem to be responsive to changes in patients’ with MS clinical condition [62]. Most published literature showed that disability level is related to QOL in a way or another [20,50,51,63]. However, other studies reported disability has no effect on quality of life [19,64]. Moreover, Wynia et al. [65] showed that QOL is better in patients with higher disability levels. A non-linear relationship between EDSS and QOL was reported [41,66]. Therefore, it was suggested that the EDSS absolute increase is not appropriate to study MS status. No doubt that the level of disability is an important issue clinically and must be measured and followed; however, there are other symptoms which seems equally or even more important which should be evaluated by clinicians.
A Dutch validation study of the Multiple Sclerosis Work Difficulties Questionnaire in relapsing remitting multiple sclerosis
Published in Disability and Rehabilitation, 2021
Elianne van Egmond, Dennis van Gorp, Cynthia Honan, Marco Heerings, Peter Jongen, Jac van der Klink, Michiel Reneman, Ernesto Beenakker, Stephan Frequin, Koen de Gans, Gerald Hengstman, Elske Hoitsma, Jop Mostert, Wim Verhagen, Désirée Zemel, Huub Middelkoop, Leo Visser, Karin van der Hiele
Participants that met the inclusion criteria and signed an informed consent form, were asked to fill in online questionnaires yearly for a period of three years. The questionnaires inquired about employment and work functioning, fatigue, self-reported cognitive and neuropsychiatric functioning, depression, anxiety, health-related quality of life, and demographic characteristics. Moreover, the persons with MS visited the outpatient MS clinics yearly and underwent neurological and neuropsychological assessments. The EDSS scores were obtained by the neurologists of the participating MS outpatient clinics during the neurological examination. For the current study, we used the data of the baseline and one-year measurements. For an extensive description of the study protocol, see van der Hiele et al. [20].