Expanded Disability Status Scale

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

Purpose[edit | edit source]

A neurologist John Kurtzke in 1983 designed a scale called Expanded Disability Status Scale (EDSS) as an advance from his previous 10 step Disability Status Scale (DSS). It is used to evaluate disability in multiple sclerosis and monitoring changes in the level of disability over time[1].

Technique[edit | edit source]

The EDSS quantify disability of MS patient based on neurological assessment by categorizing sign and symptoms in eight functional systems (FS). Furthermore, it comprises the ability to execute activities of daily living (ADL) and ambulatory function.

  1. Visual functions: visual field, visual acuity, scotoma and disc pallor.
  2. Brainstem functions: problems with speech, swallowing and nystagmus.
  3. Pyramidal functions: muscle weakness or difficulty moving limbs
  4. Cerebellar functions: ataxia, loss of balance, coordination or tremor.
  5. Sensory functions: numbness or loss of function.
  6. Bowel and bladder functions: urinary retention, urgency and bowel dysfunction
  7. Cerebral functions: problems with thinking and memory
  8. Ambulation score.

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. Each step is defined by the functional system score.[2]

[3]

Evidence[edit | edit source]

Studies have found that Expanded Disability Status Scale (EDSS) has good reliability and validity in multiple sclerosis (MS) patients. Its has found that EDSS is strongly correlated to a turkish version of the self reported disability status scale (SRDSS) which indicates good concurrent validity.

https://www.msard-journal.com/article/S2211-0348(23)00026-3/abstract

Additionally, an algorithm was developed to derive EDSS scores from previous neurological clinical documentation, and it was found to have substantial agreement with formal EDSS scores and high inter-rater agreement [3]. https://dergipark.org.tr/en/pub/balikesirsbd/issue/71251/1022783

Finally, a self-reported gait measure, the SRDSS, was developed and validated against clinical EDSS, showing good accuracy and weighted kappa [4]. https://www.msard-journal.com/article/S2211-0348(19)30955-1/fulltext

These findings suggest that the EDSS is a reliable and valid measure for assessing disability in MS patients.

Resources[edit | edit source]

Scale interpretation

https://www.nationalmssociety.org/nationalmssociety/media/msnationalfiles/brochures/10-2-3-29-edss_form.pdf

EDSS calculator

https://edss.neurol.ru/

References[edit | edit source]

  1. ↑ Expanded Disability Status Scale (EDSS) [Internet]. multiple sclerosis trust. 2020 [cited 2024 Feb 29].
  2. ↑ van Munster, C. E., & Uitdehaag, B. M. (2017). Outcome Measures in Clinical Trials for Multiple Sclerosis. CNS drugs, 31(3), 217–236.
  3. ↑ Dr. Brandon Beaber. Neurologist Explains EDSS for Multiple Sclerosis. Available from: https://www.youtube.com/watch?v=v9sFiM_lkJ4 [last accessed 29/02/2024]

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