Should we still only rely on EDSS to evaluate disability in multiple sclerosis patients? A study of inter and intra rater reliability

Cohen, Mikaël; Bresch, Saskia; Rocchi, Océane Thommel; Morain, Emmanuel; Benoit, Jeanne; Levraut, Michaël; Fakir, Salim; Landes, Cassandre; Lebrun-Frénay, Christine

doi:10.1016/j.msard.2021.103144

Cited by 25 publications

(20 citation statements)

References 5 publications

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“…3 , improvement in EDSS scores in 2019 was likely to occur in those PwMS who had had lower EDSS scores in 2009, while those with higher EDSS scores in 2009 were more likely to progress. The apparent improvement in those with lower scores may relate to inter-observer variability between 2009 and 2019, bearing in mind that inter-rater error is highest for low EDSS scores [ 19 ]. PwMS who had progressed on the ‘Any Progression’ criterion by 2019 were more likely to have demonstrated greater delay in their per-region pupillary responses in 2009 ( Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

Objective perimetry and progression of multiple sclerosis

et al. 2022

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Section: Discussionmentioning

confidence: 99%

Objective perimetry and progression of multiple sclerosis

et al. 2022

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“…The most popular and widely used instrument is the EDSS. However, considering that the inter-rater variability of EDSS is as high as 30%, establishing an objective and easily measurable biomarker would be preferable ( 95 ). Many studies have demonstrated that blood GFAP concentration is independently associated with EDSS score in NMOSD patients ( 59 , 73 , 76 – 78 , 96 ).…”

Section: Gfap In Blood As a Biomarker For Nmosdmentioning

confidence: 99%

Glial Fibrillary Acidic Protein in Blood as a Disease Biomarker of Neuromyelitis Optica Spectrum Disorders

et al. 2022

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Glial fibrillary acidic protein (GFAP) is a type III intermediate filament protein found in astrocytes in the brain. Damaged astrocytes release GFAP into cerebrospinal fluid and blood. Thus, GFAP levels in these body fluids may reflect the disease state of neuromyelitis optica spectrum disorder (NMOSD), which includes astrocytopathy, characterized by pathogenic antibodies against aquaporin 4 located on astrocytes. Recently, single-molecule array technology that can detect these synaptic proteins in blood, even in the subfemtomolar range, has been developed. Emerging evidence suggests that GFAP protein is a strong biomarker candidate for NMOSD. This mini-review provides basic information about GFAP protein and innovative clinical data that show the potential clinical value of blood GFAP levels as a biomarker for NMOSD.

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“…At present, the Expanded Disability Status Scale (EDSS) is considered the gold standard for the assessment of neurological disability and progression in patients with MS [ 20 ]. In recent years, however, several limitations of the EDSS scale have emerged, including significant inter-rater variability and underestimation of functional parameters such as cognition, vision, and upper limb function, with changes in those parameters not always being reflected by the global EDSS score [ 21 , 22 , 23 ]. In addition, EDSS has a low sensitivity at higher values.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, EDSS has a low sensitivity at higher values. EDSS scores >4–6 are mainly driven by changes in ambulatory function, while scores >6 are reflective of changes in general daily living [ 21 , 24 ]. Additional instruments have been created for more sensitive assessment of functional parameters (e.g., the Nine-Hole Peg test for manual dexterity and the Timed 25-Feet-Walk-Test for ambulation), and composite measures can be used alongside EDSS to allow a wider view of the disease [ 24 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

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MSProDiscuss™ Clinical Decision Support Tool for Identifying Multiple Sclerosis Progression

Ziemssen

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Mondragon

et al. 2022

JCM

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This article describes the rationale for the development of the MSProDiscuss™ clinical decision support (CDS) tool, its development, and insights into how it can help neurologists improve care for patients with multiple sclerosis (MS). MS is a progressive disease characterized by heterogeneous symptoms and variable disease course. There is growing consensus that MS exists on a continuum, with overlap between relapsing–remitting and secondary progressive phenotypes. Evidence demonstrates that neuroaxonal loss occurs from the outset, that progression can occur independent of relapse activity, and that continuous underlying pathological processes may not be reflected by inflammatory activity indicative of the patient’s immune response. Early intervention can benefit patients, and there is a need for a tool that assists physicians in rapidly identifying subtle signs of MS progression. MSProDiscuss, developed with physicians and patients, facilitates a structured approach to patient consultations. It analyzes multidimensional data via an algorithm to estimate the likelihood of progression (the MSProDiscuss score), the contribution of various symptoms, and the impact of symptoms on daily living, enabling a more personalized approach to treatment and disease management. Data from CDS tools such as MSProDiscuss offer new insights into disease course and facilitate informed decision-making and a holistic approach to MS patient care.

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Should we still only rely on EDSS to evaluate disability in multiple sclerosis patients? A study of inter and intra rater reliability

Cited by 25 publications

References 5 publications

Objective perimetry and progression of multiple sclerosis

Objective perimetry and progression of multiple sclerosis

Glial Fibrillary Acidic Protein in Blood as a Disease Biomarker of Neuromyelitis Optica Spectrum Disorders

MSProDiscuss™ Clinical Decision Support Tool for Identifying Multiple Sclerosis Progression

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