Amato Maria Pia, Portaccio Emilio
Department of Neurology, University of Florence, Florence, Italy.
J Neurol Sci. 2007 Aug 15;259(1-2):118-22. doi: 10.1016/j.jns.2006.06.031. Epub 2007 Mar 21.
Quantifying the clinical impact of multiple sclerosis (MS) is a critical issue for judging experimental therapies tested in clinical trials, and, in everyday practice, for optimizing individual patient care. Proposed clinical outcome measures for MS belong to four main categories. In the first, information is based on the objective neurological examination. Examples in this category include the Expanded Disability Status Scale and related instruments, the Scripps Neurological Rating Scale and the MS Impairment Scale. The second category is represented by quantitative tests of neurological function: the most important example is represented by the Multiple Sclerosis Functional Composite. In the third category, information is provided by the patient or a family member. Measures of disability and handicap (as the Incapacity Status Scale, and the Environmental Status Scale), and generic or disease-specific quality of life instruments are included in this class. Finally, the last category consists of measures which present hybrid characteristics, such as the Ambulation Index and the Cambridge Multiple Sclerosis Basic Score. To date, no single measure has emerged as the ideal outcome measure: the main advantages and disadvantages of currently available measurement tools are discussed.
量化多发性硬化症（MS）的临床影响，对于评判临床试验中所测试的实验性疗法而言是一个关键问题，并且在日常临床实践中，对于优化个体患者的治疗也至关重要。针对MS提议的临床结局测量方法主要分为四大类。第一类，信息基于客观的神经学检查。此类的例子包括扩展残疾状态量表及相关工具、斯克里普斯神经学评定量表和MS损伤量表。第二类以神经功能的定量测试为代表：最重要的例子是多发性硬化症功能综合量表。第三类，信息由患者或家庭成员提供。此类包括残疾和残障测量方法（如失能状态量表和环境状态量表），以及通用或特定疾病的生活质量工具。最后，最后一类由具有混合特征的测量方法组成，如步行指数和剑桥多发性硬化症基础评分。迄今为止，尚未有一种单一测量方法成为理想的结局测量方法：本文讨论了当前可用测量工具的主要优缺点。
