Expanded Disability Status Scale

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Original Editor - Memoona Awan
Top Contributors - Memoona Awan and Kim Jackson

Purpose

The Expanded Disability Status Scale (EDSS) is a method of quantifying disability in multiple sclerosis and monitoring changes in the level of disability over time. It is widely used in clinical trials and in the assessment of people with MS.

The scale was developed by a neurologist called John Kurtzke in 1983 as an advance from his previous 10 step Disability Status Scale (DSS). https://mstrust.org.uk/a-z/expanded-disability-status-scale-edss

Technique

The EDSS intends to capture disability of MS patients based on neurological examination by describing symptoms and signs in eight functional systems (FS). Furthermore, it encompasses ambulatory function and the ability to carry out activities of daily living (ADL).

An overall score can be given on an ordinal scale ranging from 0 (normal neurological examination) to 10 (death due to MS). Scores from 0 to 4.0 are determined by FS scores, which means that in this range the EDSS is essentially a measure of impairment. Scores from 4.0 higher basically address disability. Ambulatory function and the use of walking aids heavily determine the range of 4.0–7.0, and scores between 7.0 and 9.5 are largely determined by the ability to carry out ADL.

First of all, EDSS holds high intra- and inter-rater variability [10, 11, 17–19]. This can be explained by the subjective nature of the neurological examination itself on which the EDSS is largely based, particularly in the lower EDSS range. Also, complex and ambiguous scoring rules for the FS probably explain some of the variability. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5336539/

https://www.youtube.com/watch?v=j9UCoLNu6_A&t=13s

https://www.youtube.com/watch?v=v9sFiM_lkJ4

Resources

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References

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