Kurtzke J F
Ann N Y Acad Sci. 1984;436:347-60. doi: 10.1111/j.1749-6632.1984.tb14805.x.
The International Federation of Multiple Sclerosis Societies has been attempting to define a Minimal Data Set for multiple sclerosis following the tripartite scheme of the World Health Organization, with one rating scheme for neurologic signs, one for physical disabilities, and one for the societal impact of the disease. Current recommendations are the Disability Status Scale or the Expanded DSS plus Functional Systems for the first, Incapacity Status Scale of 16 items for the second, and Environmental Status Scale of 7 items for the third. All are graded in an ordinal (rank) scale from 0 (normal) with larger numbers for greater involvement. ISS scores range from 0-4 and ESS from 0-5 for each item. The only part of this scheme useful for measurement in clinical trials is the (E)DSS + FS. The DSS ranges from 0-10; EDSS subdivides each DSS grade 1-9 into two. FS are pyramidal, cerebellar, brain stem, sensory, bowel and bladder, visual, cerebral, or other; all save the last are graded 0-5 or 0-6. The DSS correlates well with both frequency and severity of involvement in all FS, which in turn represent a coded standard neurologic examination.
国际多发性硬化症协会一直试图按照世界卫生组织的三方方案，为多发性硬化症定义一个最小数据集，其中一个评分方案用于神经系统体征，一个用于身体残疾，另一个用于疾病的社会影响。目前的建议是，第一个采用残疾状态量表或扩展残疾状态量表加功能系统，第二个采用16项的失能状态量表，第三个采用7项的环境状态量表。所有这些都采用顺序（等级）量表进行分级，从0（正常）开始，数值越大表示受累程度越高。每个项目的失能状态量表（ISS）分数范围为0至4，环境状态量表（ESS）分数范围为0至5。该方案中对临床试验测量有用的唯一部分是扩展残疾状态量表（EDSS）加功能系统（FS）。残疾状态量表（DSS）范围为0至10；扩展残疾状态量表（EDSS）将1至9级的每个DSS等级再细分为两个等级。功能系统包括锥体束、小脑、脑干、感觉、肠道和膀胱、视觉、大脑或其他；除最后一项外，所有项目的分级均为0至5或0至6。残疾状态量表（DSS）与所有功能系统中受累的频率和严重程度都有很好的相关性，而功能系统又代表了一种编码的标准神经系统检查。
