What are the advantages and limitations of the Kurtzke Expanded Disability Status Scale (EDSS)?

Updated: Jul 12, 2021
  • Author: Stephen Kishner, MD, MHA; Chief Editor: Buck Christensen  more...
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Advantages of the EDSS are that it is widely used clinically, is easy to administer, and requires no special equipment. Its limitations are as follows:

  • It is heavily dependent on mobility
  • It is somewhat subjective in certain areas (eg, bowel and bladder function and cerebral function)
  • It is insensitive to small changes
  • It does not present an accurate picture of the patient's cognitive abilities and functional abilities in performing activities of daily living (ADLs)
  • It is nonlinear in terms of the time spent at various ranges of the scale

Several supplemental evaluations have been proposed to ameliorate the limitations of the scale, including the following:

  • Implementation of the Brief International Cognitive Assessment for MS (BICAMS) scale to reduce the subjectivity of the cognitive portion, especially in patients with an EDSS score of 4.0 or more. [6]
  • The combined use of the Timed 25-Foot Walk (T25FW), 9-Hole Peg Test (9HPT), Low Contrast Letter Acuity (LCLA), and Symbol Digit Modalities Test (SDMT), along with EDSS to increase the sensitivity to detect disease progression. [7]

Despite its limitations, the EDSS is often used as a standardization measure for clinical trials.

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