While the Expanded Disability Status Scale (EDSS) is the current gold standard for assessing clinical disability in patients with multiple sclerosis (MS), researchers believe that more precise clinical assessment tools can enhance disease management. In a recent study, the Quantified Neurological Examination (QNE) was found to have a strong correlation with the EDSS, offering a more precise means of tracking disability progression without requiring provider ratings.
In this study, researchers examined the correlation between EDSS, EDSS functional system scores (FSS), QNE global scores, subscores (qFSS), and MRI metrics in 200 examinations involving 78 patients. Overall, the global QNE score exhibited a strong correlation with the EDSS (ρ = -0.87, r2 = 0.76, P < .0001). Notably, qFSS differed significantly from the corresponding FSS for each function (P < .01), except for the visual FSS, which lacked statistical powerdue to a rating of 0 in 89% of total examinations (n = 178).
Researchers observed that EDSS primarily correlated with the pyramidal function of the lower limbs (ρ = -0.83, r2 = 0.62, P < .001) compared to the upper limbs (ρ = -0.49, r2 = 0.26, P < 0.001). In patients with an EDSS higher than 4, EDSS only correlated with lower limb function (ρ = -0.4, r2 = 0.2, P = .05). Furthermore, the QNE score and qFSS demonstrated a stronger correlation with brain MRI measurements compared to EDSS, especially in grey matter volume (ρ = 0.58, P < .0001) and cortical volume (ρ = 0.5, P < .0001).
Mikael Cohen, MD, a senior neurologist at the University Hospital Center of Nice in France, recently presented these findings at the MSMilan 2023, the 9th Joint ECTRIMS-ACTRIMS meeting held from October 11 to 13 in Milan, Italy. In an interview with NeurologyLive®, Dr. Cohen discussed how a mobile application, QNE, can address the limitations of the EDSS scale in monitoring disability in MS. He also explored the challenges the healthcare system faces when implementing digital tools for routine use and how AI and digital tools can coexist with the role of clinicians in assessing patients’ disability in MS.
Source NeurologyLive
