Ravnborg M, Grønbech-Jensen M, Jønsson A
Copenhagen MS Clinic, the National University Hospital, Denmark.
Mult Scler. 1997 Feb;3(1):31-42. doi: 10.1177/135245859700300104.
We developed a measurement scale for assessment of impairment in MS patients (MSIS) in accordance with the recommendations of WHO. The items were kept close to a standard neurologic examination, and a short battery of cognitive tests was added. Normality was assigned to the value, zero, and the theoretical maximum score was 204. Two-hundred and ten multiple sclerosis (MS) patients were rated by one neurologist on the MS impairment Scale (MSIS), the Extended Disability Status Scale (EDSS), and the Ambulation Index (AI). The median MSIS score was 52 (5-147), the median EDSS 6.5 (1-9.5), and the median AI 5 (1-5). The relation between the MSIS scores and the EDSS was best described by an exponential function (non-linear regression coefficient, R = 0.87). Sixty-two of the patients were reexamined and rated by another neurologist. The interrater reliability coefficient (R) of the MSIS was 0.95, of the EDSS 0.91, and of the AI 0.94. Forty patients were examined twice by the first neurologist. The intrarater reliability coefficient was 0.97 for the MSIS, 0.95 for the EDSS, and 0.98 for the AI. The MSIS is easy to use and is robust to observer dissimilarities. It has a monomodal univariate distribution and has a better discriminatory power than the EDSS, especially in the EDSS range 6-9, while the interrater reliability of the MSIS is at least as good as that of the EDSS and the AI.
我们根据世界卫生组织的建议，开发了一种用于评估多发性硬化症（MS）患者损伤情况的测量量表（MSIS）。量表项目与标准神经学检查紧密相关，并增加了一组简短的认知测试。将数值零定义为正常状态，理论最高分为204分。由一位神经科医生使用MS损伤量表（MSIS）、扩展残疾状态量表（EDSS）和步行指数（AI）对210例多发性硬化症（MS）患者进行评分。MSIS评分中位数为52（5 - 147），EDSS中位数为6.5（1 - 9.5），AI中位数为5（1 - 5）。MSIS评分与EDSS之间的关系用指数函数描述最佳（非线性回归系数，R = 0.87）。其中62例患者由另一位神经科医生重新检查并评分。MSIS的评分者间信度系数（R）为0.95，EDSS为0.9l，AI为0.94。40例患者由第一位神经科医生进行了两次检查。MSIS的评分者内信度系数为0.97，EDSS为0.95，AI为0.98。MSIS易于使用，对观察者差异具有较强的耐受性。它具有单峰单变量分布，并且比EDSS具有更好的区分能力，特别是在EDSS范围为6 - 9时，而MSIS的评分者间信度至少与EDSS和AI一样好。
