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J Neurol Neurosurg Psychiatry 2003;74:20-24 doi:10.1136/jnnp.74.1.20
  • Paper

The INTERMED: a screening instrument to identify multiple sclerosis patients in need of multidisciplinary treatment

  1. E L J Hoogervorst1,
  2. P de Jonge2,5,
  3. B Jelles1,
  4. F J Huyse2,
  5. I Heeres1,
  6. H M van der Ploeg3,
  7. B M J Uitdehaag1,4,
  8. C H Polman1
  1. 1Department of Neurology, VU Medical Centre, Amsterdam, Netherlands
  2. 2Department of Psychiatry, VU Medical Centre
  3. 3Department of Medical Psychology, VU Medical Centre
  4. 4Department of Clinical Epidemiology and Biostatistics, VU Medical Centre
  5. 5Department of Psychiatry, University of Groningen, Netherlands
  1. Correspondence to: 
 Dr E L J Hoogervorst, VU Medical Centre, Department of Neurology, Post box 7057, 1007 MB Amsterdam, Netherlands;
 e.hoogervorst{at}vumc.nl
  • Received 23 April 2002
  • Revised 15 August 2002

Abstract

Objective: To analyse the value of the INTERMED, a screening instrument to assess case complexity, compared with the Expanded Disability Status Scale (EDSS) and the Guy’s Neurological Disability Scale (GNDS) to identify multiple sclerosis (MS) patients in need of multidisciplinary treatment.

Methods: One hundred MS patients underwent INTERMED, EDSS, and GNDS examinations. Patient care needs were assessed by a multidisciplinary team and a goal oriented treatment plan was defined. Correlations between INTERMED, individual INTERMED domains, EDSS, GNDS sum score, and total number of proposed disciplines involved in the treatment plan were studied.

Results: Mean (SD) age was 40.6 (10.1) years. Median scores were 14.0 for the INTERMED, 4.0 for the EDSS, and 13.5 for the GNDS sum score. Moderate correlations were found between the INTERMED sum score and EDSS (r=0.59) and GNDS sum score (r=0.60). The number of disciplines as proposed by the multidisciplinary team showed the highest statistically significant correlation with the INTERMED sum score (r=0.41) compared with EDSS (r=0.32) and GNDS sum score (r=0.34). No significant or only weak correlations were found between the psychological domain of the INTERMED and EDSS or GNDS.

Conclusion: The findings in this study show that there is an additional value of the INTERMED compared with the EDSS and GNDS in identifying MS patients in need of multidisciplinary treatment. The INTERMED domains show the area of the patient’s vulnerability and care needs: especially the INTERMED’s psychological and social domains may guide the clinician to deal with specific problems that complicate healthcare delivery.

Footnotes

  • Competing interests: none declared.

  • See Editorial Commentary p 5

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