SynthesisBMC neurology2014
Systematic literature review and validity evaluation of the Expanded Disability Status Scale (EDSS) and the Multiple Sclerosis Functional Composite (MSFC) in patients with multiple sclerosis.
Synthesis in BMC neurology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 305 papers, 18 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Cladribine Tablets After Treatment With Natalizumab (CLADRINA)
Safety of Cultured Allogeneic Adult Umbilical Cord Derived Mesenchymal Stem Cell Intravenous Infusion for the Treatment of Multiple Sclerosis
Who cites it
305 citing papers in PubMed, 18 syntheses or guidelines pooled it.
- Characterizing gait in people with multiple sclerosis using digital data from smartphone sensors: A proposed framework.Multiple sclerosis (Houndmills, Basingstoke, England) · 2025Pooled it
- Rituximab for people with multiple sclerosis.The Cochrane database of systematic reviews · 2025Pooled it
- Azathioprine for people with multiple sclerosis.The Cochrane database of systematic reviews · 2024Pooled it
- Immunomodulators and immunosuppressants for progressive multiple sclerosis: a network meta-analysis.The Cochrane database of systematic reviews · 2024Pooled it
- Efficacy and safety of stem cell transplantation for multiple sclerosis: a systematic review and meta-analysis of randomized controlled trials.Scientific reports · 2024Pooled it
- Neuroimaging markers and disability scales in multiple sclerosis: A systematic review and meta-analysis.PloS one · 2024Pooled it
- Effectiveness of transcranial direct current stimulation on balance and gait in patients with multiple sclerosis: systematic review and meta-analysis of randomized clinical trials.Journal of neuroengineering and rehabilitation · 2023Pooled it
- Clinical efficacy and safety of melatonin supplementation in multiple sclerosis: a systematic review.Inflammopharmacology · 2023Pooled it
- Effect of Music Based Therapy Rhythmic Auditory Stimulation (RAS) Using Wearable Device in Rehabilitation of Neurological Patients: A Systematic Review.Sensors (Basel, Switzerland) · 2023Pooled it
- The effect of exercise on cognitive function in people with multiple sclerosis: a systematic review and meta-analysis of randomized controlled trials.Journal of neurology · 2023Pooled it
- Understanding lifestyle self-management regimens that improve the life quality of people living with multiple sclerosis: a systematic review and meta-analysis.Health and quality of life outcomes · 2022Pooled it
- The role of machine learning in developing non-magnetic resonance imaging based biomarkers for multiple sclerosis: a systematic review.BMC medical informatics and decision making · 2022Pooled it
- How should we define a 'good' outcome from encephalitis? A systematic review of the range of outcome measures used in the long-term follow-up of patients with encephalitis.Clinical medicine (London, England) · 2022Pooled it
- Are Cell-Based Therapies Safe and Effective in the Treatment of Neurodegenerative Diseases? A Systematic Review with Meta-Analysis.Biomolecules · 2022Pooled it
- Gray Matter Atrophy in the Cortico-Striatal-Thalamic Network and Sensorimotor Network in Relapsing-Remitting and Primary Progressive Multiple Sclerosis.Neuropsychology review · 2021Pooled it
- Rituximab for people with multiple sclerosis.The Cochrane database of systematic reviews · 2021Pooled it
- Advanced Oxidative Protein Products Role in Multiple Sclerosis: a Systematic Review and Meta-analysis.Molecular neurobiology · 2021Pooled it
- Effectiveness of Motor Imagery on Motor Recovery in Patients with Multiple Sclerosis: Systematic Review.International journal of environmental research and public health · 2021Pooled it
- Five Years of Ublituximab in Multiple Sclerosis: ULTIMATE I and II Open-Label Extension Study.JAMA neurology · 2026Trial
- Overall Disability Response Score: An integrated endpoint to assess disability improvement and worsening over time in patients with multiple sclerosis.Multiple sclerosis (Houndmills, Basingstoke, England) · 2022Trial
245 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere are a number of instruments that describe severity and progression of multiple sclerosis and they are increasingly used as endpoints to assess the effectiveness of therapeutic interventions. We examined to what extent the psychometric properties of two accepted instruments--EDSS and MSFC--meet methodological standards and the value they have in clinical trials.
methodsWe conducted a systematic literature search in relevant databases [MEDLINE (PubMed), ISI Web of Science, EMBASE, PsycINFO & PSYNDEX, CINAHL] yielding 3,860 results. Relevant full-text publications were identified using abstract and then full-text reviews, and the literature was reviewed.
resultsFor evaluation of psychometric properties (validity, reliability, sensitivity of change) of EDSS and MSFC, 120 relevant full-text publications were identified, 54 of them assessed the EDSS, 26 the MSFC and 40 included both instruments. The EDSS has some documented weaknesses in reliability and sensitivity to change. The main limitations of the MSFC are learning effects and the z-scores method used to calculate the total score. However, the methodological criterion of validity applies sufficiently for both instruments.For use in clinical studies, we found the EDSS to be preferred as a primary and secondary outcome measure in recent studies (50 EDSS, 9 MSFC).
conclusionsRecognizing their strengths and weaknesses, both EDSS and MSFC are suitable to detect the effectiveness of clinical interventions and to monitor disease progression. Almost all publications identify the EDSS as the most widely used tool to measure disease outcomes in clinical trials. Despite some limitations, both instruments are accepted as endpoints and neither are discussed as surrogate parameters in identified publications. A great advantage of the EDSS is its international acceptance (e.g. by EMA) as a primary endpoint in clinical trials and its broad use in trials, enabling cross-study comparisons.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.