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Quality of life as a predictor for change in disability in MS

From the Department of Public Health and Primary Health Care (Drs. Nortvedt and Riise), University of Bergen; and the Department of Neurology (Drs. Myhr and Nyland), Haukeland University Hospital, Bergen, Norway.

Address correspondence and reprint requests to Research Fellow M.W. Nortvedt, University of Bergen, Department of Public Health and Primary Health Care, Ulriksdal 8C, N-5009 Bergen, Norway; monica.nortvedt{at}hib.no

OBJECTIVE: To investigate the predictive value of quality of life on changes in disability measured by the Expanded Disability Status Scale (EDSS).

BACKGROUND: There are few good prognostic factors for disease development in MS. Quality of life and self-rated health have been shown to be highly predictive of morbidity and disease development in heart disease and cancer.

METHODS: Data on quality of life (SF-36 Health Survey) were ascertained at baseline for 97 relapsing-remitting patients with MS participating in a short-term clinical trial on interferon -2a. These scores were correlated with change in EDSS scores 1 year later, 6 months after treatment ended.

RESULTS: Low scores on the SF-36 mental health scale were correlated with increased (worsened) EDSS scores 1 year later (r = -0.29, p = 0.006). The results were not altered by adjusting for disease activity at baseline, which was measured by the number gadolinium-enhanced MRI lesions, relapse rate for the preceding 2 years, and baseline EDSS score. Similar results were found for self-rated health (according to the first question of the SF-36).

CONCLUSIONS: These findings reinforce the importance of incorporating the patients’ evaluation of their quality of life during treatment. Further, assessing such measures is important in evaluating effects in treatment trials in MS.

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