Hoogervorst E L J, Kalkers N F, Cutter G R, Uitdehaag B M J, Polman C H
Department of Neurology, VU Medical Center, Amsterdam, The Netherlands.
Mult Scler. 2004 Feb;10(1):55-60. doi: 10.1191/1352458504ms972oa.
To prospectively characterize the relation between two-year changes in functional impairment as measured by the Multiple Sclerosis Functional Composite (MSFC) and changes in patient perceived disability as measured by the Guy's Neurological Disability Scale (GNDS).
One hundred and eighty-eight patients with multiple sclerosis (MS) were recruited at our outpatient clinic. Impairment and disability were assessed using the MSFC and GNDS at baseline and follow-up. Longitudinal correlations were studied between changes in MSFC and GNDS and their corresponding components. We also studied changes in GNDS in relation to what can be classified as a reliable change in MSFC; for example, 20% change in each MSFC component or a change of 0.5 in total MSFC score. In addition, we studied the change in total number of GNDS subcategories with a score of 3 or higher in relation to the predefined MSFC changes, these subcategories being indicative of the requirement for help by another person.
Despite good cross-sectional correlations between MSFC and GNDS, no significant correlation was found between longitudinal changes in MSFC and GNDS. Analysing the change in GNDS in relation to the predefined MSFC changes shows that GNDS changes are nicely rank ordered when more stringent definitions of reliable change were applied. In addition, analysing the number of GNDS subcategories scored 3 or higher indicate that there is a profile of worsening on the MSFC being associated with increase in the amount of help required from others.
Our longitudinal data suggest that a reliable change is associated with a likewise change in patient perceived disability, the smallest reliable change being identified by at least 20% change in each MSFC component.
前瞻性地描述用多发性硬化功能综合评分（MSFC）衡量的功能损害的两年变化与用盖伊神经功能残疾量表（GNDS）衡量的患者感知残疾变化之间的关系。
在我们的门诊招募了188例多发性硬化（MS）患者。在基线和随访时使用MSFC和GNDS评估损害和残疾情况。研究了MSFC和GNDS变化及其相应组成部分之间的纵向相关性。我们还研究了GNDS的变化与可归类为MSFC可靠变化的情况之间的关系；例如，每个MSFC组成部分变化20%或MSFC总分变化0.5。此外，我们研究了GNDS中得分3或更高的子类别总数的变化与预定义的MSFC变化之间的关系，这些子类别表明需要他人帮助。
尽管MSFC和GNDS之间存在良好的横断面相关性，但未发现MSFC和GNDS的纵向变化之间存在显著相关性。分析GNDS相对于预定义的MSFC变化的变化表明，当应用更严格的可靠变化定义时，GNDS变化具有良好的排序。此外，分析得分3或更高的GNDS子类别数量表明，MSFC恶化的情况与他人所需帮助量的增加相关。
我们的纵向数据表明，可靠变化与患者感知残疾的类似变化相关，最小的可靠变化由每个MSFC组成部分至少20%的变化确定。
