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How responsive is the Multiple Sclerosis Impact Scale (MSIS-29)? A comparison with some other self report scales
  1. J C Hobart1,
  2. A Riazi2,
  3. D L Lamping3,
  4. R Fitzpatrick4,
  5. A J Thompson2
  1. 1Murdoch University, Perth, Western Australia
  2. 2Neurological Outcome Measures Unit, University College London, London, UK
  3. 3Health Services Research Unit, London School of Hygiene and Tropical Medicine, London, UK
  4. 4Department of Public Health and Primary Care, University of Oxford, Oxford, UK
  1. Correspondence to:
 Dr Jeremy Charles Hobart
 Peninsula Medical School, Derriford Hospital, Plymouth, Devon PL6 8DH, UK; Jeremy.Hobartpms.ac.uk

Abstract

Objectives: To compare the responsiveness of the Multiple Sclerosis Impact Scale (MSIS-29) with other self report scales in three multiple sclerosis (MS) samples using a range of methods. To estimate the impact on clinical trials of differing scale responsiveness.

Methods: We studied three discrete MS samples: consecutive admissions for rehabilitation; consecutive admissions for steroid treatment of relapses; and a cohort with primary progressive MS (PPMS). All patients completed four scales at two time points: MSIS-29; Short Form 36 (SF-36); Functional Assessment of MS (FAMS); and General Health Questionnaire (GHQ-12). We determined: (1) the responsiveness of each scale in each sample (effect sizes): (2) the relative responsiveness of competing scales within each sample (relative efficiency): (3) the differential responsiveness of competing scales across the three samples (relative precision); and (4) the implications for clinical trials (samples size estimates scales to produce the same effect size).

Results: We studied 245 people (64 rehabilitation; 77 steroids; 104 PPMS). The most responsive physical and psychological scales in both rehabilitation and steroids samples were the MSIS-29 physical scale and the GHQ-12. However, the relative ability of different scales to detect change in the two samples was variable. Differing responsiveness implied more than a twofold impact on sample size estimates.

Conclusions: The MSIS-29 was the most responsive physical and second most responsive psychological scale. Scale responsiveness differs notably within and across samples, which affects sample size calculations. Results of clinical trials are scale dependent.

  • DR, differential responsiveness
  • ES, effect size
  • FAMS, Functional Assessment of MS
  • GHQ-12, 12-item version of the General Health Questionnaire
  • MS, multiple sclerosis
  • PPMS, primary progressive MS
  • RE, relative measurement efficiency
  • RP, relative measurement precision
  • SF-36, Short-Form 36 Health Survey
  • SRM, standardised response means
  • clinical trials
  • multiple sclerosis
  • Multiple Sclerosis Impact Scale
  • quality of life
  • responsiveness

https://doi.org/10.1136/jnnp.2005.064584

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    Footnotes

    • This study was funded by grants from the NHS Health Technology Assessment Programme (but the views and opinions expression are not necessarily those of the NHS Executive) and the MS Society of Great Britain and Northern Ireland. Dr Hobart received support from the Royal Society of Medicine (in the form of an Ellison-Cliffe Travelling Fellowship) and the MS Society of Great Britain and Northern Ireland for a recent sabbatical at Murdoch University, Perth, Western Australia where these data were analysed and this paper written.

    • Competing interests: none declared