Echelle minimale d'invalidité et sclérose en plaques: résultats de l'évaluation de 200 patients

: The Minimal Record of Disability (MRD) for Multiple Sclerosis (MS) evaluates impairment in MS through 4 sets of data: Demographic Data, Kurtzke Disability Status Scale (DSS), Incapacity Status Scale (ISS) and Environmental Status Scale (ESS). We assessed with the 1985 version of MRD 200 consecutive patients attending our MS clinic during a 6 months period. 170 were out-patients and 30 inpatients. Diagnosis was definite in 197 and probable in 3. ESS and ISS were rated by a medical student according to a planned interview. The validity and internal consistency of DSS, ISS and ESS were evaluated by dependence analysis of each item to the sum of all items, and multivariate analysis was carried out on the first 15 items of ISS. Main clinical data were: age 43.0 +/- 11.8 years; age at onset of MS: 27.3 +/- 10.3; sex ratio (F/M): 1.75/1; mean DSS score: 4.6 +/- 0.1. Administration of MRD was easy and general acceptance was good. Some refinement in wording is needed for 5 items of ISS--mainly for "mood and thought disturbances" and "mentation" which do not score adequate mood and intellectual impairment in MS--and for 2 items of ESS. These 2 scales are otherwise of practical use and cover all the area of disability and handicap in MS. The levels of internal consistency of DSS, ISS and ESS are high, as well as correlations between the 3 scales (p less than 0.001). Correlations with age and duration of MS were established for total scores of DSS but not ISS and ESS. Our data confirms the validity of MRD as an evaluation tool of MS patients; they show that MRD can be applied with minor modifications to MS patients and support its use in therapeutic trials, rehabilitation and socio-economic inquiries.