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Interrater variability with the Expanded Disability Status Scale (EDSS) and Functional Systems (FS) in a multiple sclerosis clinical trial
Abstract
We describe the interrater variability in the Expanded Disability Status Scale (EDSS) and Functional Systems (FS) in a multiple sclerosis clinical trial. Two physicians blinded to their previous assessments and to each other's scores consecutively examined 168 patients (545 paired examinations). Perfect agreement on the assignment of the disability scores ranged from 48% (cerebellar functional group) to 69% (EDSS and pyramidal functional group). Only 31% to 62% of this agreement occurred independently of that expected by chance (kappa). With the exception of the cerebellar and sensory functional groups, agreement within 1 step occurred in at least 92% of cases. These findings suggest that differences of a single step on these scales may not reflect an important functional change. We recommend that at least a 2-step change (1.0 point on the EDSS and 2 points on the FS) is needed to be confident of an important change in the degree of disability or response to treatment in this disease.
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Cited by
Kobayashi, T., Siegmund, B., Le Berre, C., Wei, S. C., Ferrante, M., Shen, B., Bernstein, C. N., Danese, S., Peyrin-Biroulet, L., & Hibi, T. (2020) · Nature Reviews Disease Primers · doi:10.1038/s41572-020-0205-x · Cited by 1,649
Kappos, L. (1998) · The Lancet · doi:10.1016/s0140-6736(98)10039-9 · Cited by 936
Miller, D. H., Albert, P. S., Barkhof, F., Francis, G., Frank, J. A., Hodgkinson, S., Lublin, F. D., Paty, D. W., Reingold, S. C., & Simon, J. (1996) · Annals of Neurology · doi:10.1002/ana.410390104 · Cited by 444
Interferon beta-1b in secondary progressive MS: Results from a 3-year controlled study
The North American Study Group on Interferon beta-1b in Secondary Progressive MS (2004) · Neurology · doi:10.1212/01.wnl.0000146958.77317.3e · Cited by 423
Validity of performance scales for disability assessment in multiple sclerosis
Marrie, R. A., & Goldman, M. (2007) · Multiple Sclerosis Journal · doi:10.1177/1352458507078388 · Cited by 285
Metadata
- Authors
- Noseworthy, J. H., Vandervoort, M. K., Wong, C. J., & Ebers, G. C.
- Venue
- Neurology
- Published
- 1990-06
- Volume
- 40
- Issue
- 6
- Pages
- 971-971
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- OpenAlex
- W2074356121
- Cited by
- 328
- References
- 0
- FWCI
- 5.52
- Type
- journal article
- Language
- en
- Open access
- closed
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- CoChat. (2026). Citation check: Interrater variability with the Expanded Disability Status Scale (EDSS) and Functional Systems (FS) in a multiple sclerosis clinical trial. https://app.cochat.ai/papers/10.1212/wnl.40.6.971
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- Noseworthy, J. H., Vandervoort, M. K., Wong, C. J., & Ebers, G. C. (1990). Interrater variability with the Expanded Disability Status Scale (EDSS) and Functional Systems (FS) in a multiple sclerosis clinical trial. Neurology. https://doi.org/10.1212/wnl.40.6.971
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