European validation of a standardized clinical description of multiple sclerosis
European validation of a standardized clinical description of multiple sclerosis
复制标题
DOI：
10.1007/s00415-004-0567-0
复制
发表时间：
2004-12-01
影响因子：
6
通讯作者：
Confavreux, C
中科院分区：
文献类型：
--
作者：
Amato, MP;Grimaud, J;Confavreux, C
目的EDMUS系统是一个专门针对多发性硬化（MS）描述的临床数据库。EDMUS系统评估（EDMUS Evaluation of the EDMUS system）研究是一项欧洲项目，有两个目标：1）评估整个EDMUS系统的检查者间可靠性; 2）验证EDMUS分级量表（EGS），这是Kurtzke残疾状态量表（DSS）的简化版本。方法该方案包括在6个欧洲中心（巴里，巴塞尔，佛罗伦萨，伦敦，里昂，维尔茨堡）的12名神经科医生成对工作。他们独立评估了中心的30名多发性硬化症患者，并填写了EDMUS表格。在MS发病史、临床病程和病程分类中选择关键项目评估系统的可靠性。患者的临床检查允许评估Kurtzke扩展残疾状态量表（EDSS）和EGS。在适当的情况下，根据kappa和加权kappa指数测量一致性水平。结果180例确诊或疑似MS患者中男性占37%。年龄为35.8 ± 9.6岁（平均值± SD），疾病持续时间为7.8 ± 5.7年，平均EDSS评分为4.1 ± 2.2。67%的患者的病程为复发缓解型，22%为继发性进展型，11%为从疾病发作开始进展型。对于历史的关键项目，检查员之间的信度水平从中等到优秀不等。关于残疾量表，EDSS和EGS的完全一致率分别为59%和78%。相关系数r=0.94，p
Objectives The EDMUS system is a clinical database specifically tailored to the description of multiple sclerosis (MS). The EVALUED (Evaluation of the EDMUS system) study is an European project with two objectives: 1) to assess the inter-examiner reliability of the whole EDMUS system; 2) to validate the EDMUS-Grading Scale (EGS),which is a simplified version of the Kurtzke Disability Status Scale (DSS). Methods The protocol included 12 neurologists working in pairs within six European centres (Bari, Basel, Florence, London, Lyon, Wurzburg). They assessed independently 30 MS patients in their centre, filling in the EDMUS forms. The reliability of the system was assessed on selected key items in the history of the MS onset, the clinical course and the disease course classification. The clinical examination of the patients permitted an assessment of the Kurtzke Expanded Disability Status Scale (EDSS) and the EGS. Level of agreement was measured in terms of kappa and weighted kappa indexes whenever appropriate. Results The study included 180 patients with definite or probable MS of whom 37% were males. Age was 35.8+/-9.6 years (mean +/-SD), disease duration 7.8+/-5.7 years, and mean EDSS score 4.1+/-2.2. The disease course was relapsing-remitting in 67%, secondary progressive in 22%, and progressive from disease onset in 11%. For key items of the history, the inter-examiner reliability level ranged from moderate to excellent. Concerning the disability scales, perfect agreement was reached in 59 % for EDSS and 78% for EGS. The close correlation and linear association (r=0.94, p