Integration of the Expanded Disability Status Scale with ambulation, visual and cognitive tests improves disability assessment (P13-3.003)

Abstract

<h3>Objective:</h3> Aim of our study was to estimate the difference between the Expanded Disability Status Scale (EDSS) obtained during routine visits, or after specific tests. <h3>Background:</h3> The EDSS is usually calculated through a neurological examination with self-reported performance. This may lead to incorrect assessment of Functional System scores (FSs). <h3>Design/Methods:</h3> We enrolled 670 MS patients that underwent a regular neurology consultation, and visual evaluation using optotype tables, ambulation evaluation with a rodometer, and cognitive assessment with the Brief International Cognitive assessment for MS (BICAMS). We calculated a new integrated EDSS (iEDSS) using the refined values of the FS and compared it to the standard EDSS. <h3>Results:</h3> Visual, cerebral and ambulation FSs were significantly higher compared with the self-reported counterpart [+1.169 (95%CI 1.077, 1.262; p&lt;0.001), +0.727 (95%CI 0.653, 0.801; p&lt;0.001) and +0.822 (95%CI 0.705, 0.939; p&lt;0.001), respectively]. Mean iEDSS was higher than EDSS (+0.642; p&lt;0.001). Visual acuity tests worsened the EDSS in 31% of cases, cognitive tests in 10%, ambulation measurement in 35%, all three measurements in 59% of cases. <h3>Conclusions:</h3> Objective measurement of FSs results in a more accurate EDSS score in almost two-thirds of cases. This could lead to a more thorough evaluation of patients in the transition or progressive phase. <b>Disclosure:</b> Dr. Sacca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Sacca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Almirall. Dr. Sacca has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Argenx. Dr. Sacca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Avexis. Dr. Sacca has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Sacca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lexeo therapeutics. Dr. Sacca has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Sacca has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Sacca has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Sacca has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Takeda. Mr. Carotenuto has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Merk, Novartis, Roche and Almirall. The institution of Mr. Carotenuto has received research support from ALMIRALL. The institution of Mr. Carotenuto has received research support from Carotenuto Antonio. Marcello Moccia, 2019 has nothing to disclose. Roberta Lanzillo has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck, Biogen. Roberta Lanzillo has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen, Roche, Novartis. Dr. Petracca has nothing to disclose. Dr. Brescia Morra has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Brescia Morra has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NOVARTIS. Dr. Brescia Morra has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BIOGEN. Dr. Brescia Morra has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ROCHE. Dr. Brescia Morra has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TEVA. Dr. Brescia Morra has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ALMIRALL. Dr. Brescia Morra has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for MERK. Dr. Brescia Morra has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for MERK. The institution of Dr. Brescia Morra has received research support from FISM. Dr. Brescia Morra has a non-compensated relationship as a PI with FISM that is relevant to AAN interests or activities. Cinzia Valeria Russo has nothing to disclose.