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Multiple sclerosis (MS) and its treatment have broad-ranging effects on quality of life. This article reviews recent efforts to assess the impact of MS on activities of daily living (ADLs) and health-related quality of life (HRQL), and describes the development of the Multiple Sclerosis Quality of Life Inventory (MSQLI). The MSQLI is a modular MS-specific HRQL instrument consisting of a widely-used generic measure, the Health Status Questionnaire (SF-36), supplemented by nine symptom-specific measures (covering fatigue, pain, bladder function, bowel function, emotional status, perceived cognitive function, visual function, sexual satisfaction, and social relationships). Content validation consisted of evaluating its adherence to a conceptual model of the impact of MS, and review by MS specialists (neurologists and allied health professionals), HRQL experts, patients, and caregivers. The reliability and construct validity of the MSQLI were rigorously evaluated in a field test with 300 North American patients (198 female, 102 male) with definite MS (Poser criteria) and a broad range of physical impairment (EDSS=0. 0-8.5). This article concludes by comparing the MSQLI with two other MS-specific HRQL measures (MS Quality of Life-54 (QOL-54) and Functional Assessment of Multiple Sclerosis (FAMS)) and discussing key issues to consider in selecting an HRQL instrument for a collaborative database.
Aim: The aim of this trial was to evaluate the effects of albendazole (ALB) on cyst disappearance, reduction of the number of cysts and seizure recurrence. Methods: 178 patients with new onset symptoms due to active or transitional neurocysticercosis were randomly assigned to receive either 800 mg of ALB daily or placebo for 8 days. All patients also received prednisone. Imaging studies were done at baseline and at months 1, 6 and 12 of follow-up. Results: Active cysts were identified in 59 of 88 people randomised to ALB and 57 of the 90 in the placebo arm.
In research studies of essential tremor (ET), monetary and geographic factors often necessitate diagnosis by interview rather than by examination. Few attempts have been made to determine the validity of a screening instrument for ET. A total of 242 subjects (33 definite or probable ET, 54 possible ET, and 155 normal) were part of a community-based family study of ET in northern Manhattan. Subjects underwent a tremor interview and videotaped tremor examination. The interview included 12 screening questions for ET. Two neurologists rated the severity of tremor on videotape and assigned diagnoses. The subjects' responses to the 12 screening questions were compared with the neurologic examination and the neurologists' diagnoses. There was an association between the number of affirmative responses on the 12-item screen and the severity of tremor during the videotaped tremor examination (r = 0.66, p < 0.01). Including those with probable and definite ET and defining a positive screen result as an affirmative response to at least 1 of 12 screening questions, the sensitivity of the screening questionnaire was 73%, the specificity was 96%, and the positive predictive value was 80%. The responses to the questionnaire closely correlated with the severity of tremor on neurologic examination. The questionnaire had moderate validity for subjects with probable or definite ET; subjects with mild ET often screened negative. Hence, in population-based studies and family studies of ET, it is important to examine all subjects for the presence of mild asymptomatic ET.
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