Background: Patient-Reported Expanded Disability Status Scale (PREDSS) tools are an attractive alternative
to the Expanded Disability Status Scale (EDSS) during long term or geographically challenging
studies, or in pressured clinical service environments.
Objectives: Because the studies reporting these tools have used different metrics to compare the PREDSS
and EDSS, we undertook an individual patient data level analysis of all available tools.
Methods: Spearman’s rho and the Bland–Altman method were used to assess correlation and agreement
respectively.
Results: A systematic search for validated PREDSS tools covering the full EDSS range identified eight
such tools. Individual patient data were available for five PREDSS tools. Excellent correlation was
observed between EDSS and PREDSS with all tools. A higher level of agreement was observed with
increasing levels of disability. In all tools, the 95% limits of agreement were greater than the minimum
EDSS difference considered to be clinically significant. However, the intra-class coefficient was greater
than that reported for EDSS raters of mixed seniority. The visual functional system was identified as the
most significant predictor of the PREDSS–EDSS difference.
Conclusion: This analysis will (1) enable researchers and service providers to make an informed choice
of PREDSS tool, depending on their individual requirements, and (2) facilitate improvement of current
PREDSS tools
Multiple Sclerosis 2015
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