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Stay at home with the amyotrophic lateral sclerosis functional rating scale
  1. Christopher J McDermott1,2
  1. 1University of Sheffield, Sheffield S10 2RX, UK
  2. 2NIHR Sheffield Biomedical Research Centre, Sheffield, UK
  1. Correspondence to Professor Christopher J McDermott, Sheffield Institute of Translational Neuroscience, Department of Neuroscience, University of Sheffield, Sheffield S10 2RX, UK; c.j.mcdermott{at}sheffield.ac.uk

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Can we reduce trial burden and improve remote clinical monitoring for people living with amyotrophic lateral sclerosis with an imperfect tool?

In this issue, Bakker and colleagues report on the development and assessment of the performance of a self-administered version of the revised amyotrophic lateral sclerosis functional rating scale (ALSFRS-R).1

The ALSFRS, subsequently revised to ALSFRS-R is a functional outcome measure for ALS trials and has been shown to correlate with survival and muscle strength.2 As an outcome measure, it is not without its problems including multidimensionality, non-linearity, poor sensitivity to change in latter stages of disease and the absence of a cognitive function domain.3 4

Survival has traditionally been seen as the gold standard outcome measure; however, such trials are long and expensive. This has led to …

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