title: Importance of an individual's evaluation of functional status for health-related quality of life in patients with multiple sclerosis.
abstract: BACKGROUND
  Quantifying the clinical impact of multiple sclerosis (MS) is one of the most important determinants for optimizing individual patient care. Useful clinical measures for MS can be evaluated from different perspectives.
  
  
  OBJECTIVE
  This cross-sectional study compared physical disability and functional status as assessed by a neurologist and by a patient and explored how they are associated with the health-related quality of life (HRQoL).
  
  
  METHODS
  We collected data from 223 patients. One neurologist scored functional disability using the Kurtzke's Expanded Disability Status Scale (EDSS) and patients evaluated their functional status using the Incapacity Status Scale (ISS). HRQoL was assessed using the Physical and Mental Component Summary (PCS, MCS) of the Short Form-36 Health Survey (SF-36). Multiple linear regressions were applied to analyze the data.
  
  
  RESULTS
  Total EDSS and ISS scores correlated significantly (r = .67; p ≤ .001). Regression analyses showed that EDSS was significantly related to PCS, but not to MCS. After adding ISS into the analysis the association between EDSS and PCS became non-significant. ISS contributed significantly to the explained variance in both models. The final model explained 49% of the total variance for PCS and 15% for MCS.
  
  
  CONCLUSIONS
  Functional disability as measured by a neurologist (EDSS) is associated with PCS, but not with MCS, whereas functional disability as measured by patients (ISS) is significantly associated with both HRQoL dimensions. Neurologists should target their attention more on patients' evaluations of their functional status in order to detect the most bothersome problems that are affecting a patient's quality of life.
authors.affiliation: Graduate School Kosice Institute for Society and Health, Safarik University, Kosice, Slovakia; Institute of Public Health - Department of Social Medicine, Faculty of Medicine, Safarik University, Kosice, Slovakia.
authors.forename: Miriam
authors.initials: M
authors.lastname: Gavelova
authors.affiliation: Graduate School Kosice Institute for Society and Health, Safarik University, Kosice, Slovakia; Institute of Public Health - Department of Social Medicine, Faculty of Medicine, Safarik University, Kosice, Slovakia. Electronic address: iveta.nagyova@upjs.sk.
authors.forename: Iveta
authors.initials: I
authors.lastname: Nagyova
authors.affiliation: Graduate School Kosice Institute for Society and Health, Safarik University, Kosice, Slovakia; Institute of Public Health - Department of Social Medicine, Faculty of Medicine, Safarik University, Kosice, Slovakia; Nephrology and Dialysis Centre Fresenius, Kosice, Slovakia.
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Rosenberger
authors.affiliation: Graduate School Kosice Institute for Society and Health, Safarik University, Kosice, Slovakia; 1st Department of Psychiatry, Faculty of Medicine, Safarik University, Kosice, Slovakia.
authors.forename: Martina
authors.initials: M
authors.lastname: Krokavcova
authors.affiliation: Department of Neurology, Faculty of Medicine, Safarik University, Kosice, Slovakia.
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Gdovinova
authors.affiliation: Department of Community & Occupational Health, University of Groningen, University Medical Centre Groningen, the Netherlands.
authors.forename: Johan W
authors.initials: JW
authors.lastname: Groothoff
authors.affiliation: Graduate School Kosice Institute for Society and Health, Safarik University, Kosice, Slovakia; Department of Community & Occupational Health, University of Groningen, University Medical Centre Groningen, the Netherlands.
authors.forename: Jitse P
authors.initials: JP
authors.lastname: van Dijk
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D006233:Persons with Disabilities; D005260:Female; D006262:Health; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis; D011788:Quality of Life; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Expanded Disability Status Scale; Health-related quality of life; Incapacity Status Scale; Multiple sclerosis; Neurological impairment