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The following abstract was not printed with the article by E L J Hoogervorst, M J Eikelenboom, B M J Uitdehaag, and C H Polman (One year changes in disability in multiple sclerosis: neurological examination compared with patient self report) in the April issue of JNNP (JNNP 2003;74:439–42).
Objective: To characterise the relation between one year changes in neurologist rating of neurological exam abnormalities as measured by the EDSS and changes in patient perceived disability as measured by the GNDS in patients with MS.
Methods: 250 patients with MS were recruited at an outpatient clinic. Disability at baseline and one year follow up was assessed using the EDSS and GNDS. Correlations between change in EDSS, GNDS-sum score, functional systems, and GNDS subcategories were studied as well as the significance of changes in EDSS associated with changes in perceived disability.
Results: The correlation between one year changes in EDSS v GNDS was substantially lower (0.19) than cross-sectional correlations between EDSS and GNDS, either at baseline (0.62) or at follow up (0.77). Notably, changes in functional system scores that are based on neurological examination are poorly or not at all correlated with changes in disability as perceived by the patient. Analysing the impact of a significant worsening in EDSS score we found that this was associated with significant worsening, insignificant change, and significant improvement in the patients’ perceived disability in 45%, 39%, and 15% of patients, respectively.
Conclusion: Patients’ perception of change in disability differs not only quantitatively but also qualitatively from that of an examining physician. There are true differences in change as perceived by the patient and measured by the physician and changes in many dimensions of disability are relevant to the patient and have no measurable impact on the EDSS.
The authors of the short report entitled Paraneoplastic ophthalmoplegia and subacute motor axonal neuropathy associated with anti-GQ1b antibodies in a patient with malignant melanoma, published in the April issue 2003 of JNNP (2003;74:507–9), were listed in the incorrect order. The author order should read as follows: L Kloos, C W Ang, W Kruit, G Stoter, and P Sillevis.