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Logo for the Journal of Rehab R&D
Volume 43 Number 1, January/February 2006
Pages 35 — 44


Abstract- Quality of life for veterans with multiple sclerosis on disease-modifying agents: Relationship to disability

Joseph B. Guarnaccia, MD;1* Mihaela Aslan, PhD;2 Theresa Z. O'Connor, PhD;2 MaryAnn Hope, MS;2
Lewis Kazis, ScD;3 C. Michael Kashner, PhD;4-5 John Booss, MD6

1The Multiple Sclerosis Treatment Center, Griffin Hospital, Derby, CT; 2Department of Veterans Affairs (VA), Cooperative Studies Program Center, VA Connecticut Healthcare System (VACHS), West Haven, CT; 3Health Outcomes Technologies Program, Boston University School of Public Health and Center for Health Quality Outcomes and Economic Research, VA Medical Center, Bedford, MA; 4VA Health Services Research and Development Service, North Texas Health Care System, Dallas, TX; 5Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX; 6Department of Neurology, VACHS, West Haven, CT
Abstract — Our objective was to compare self-reported health-related quality of life (HRQOL) for U.S. veterans with multiple sclerosis (MS) on disease-modifying agents with provider reports of HRQOL from standard disability measures. We conducted a 3-year prospective observational study of 204 subjects who used interferon beta or glatiramer acetate and compared subjects' responses on the Veterans Short-Form 36 (VSF-36) (36-item short-form functional status assessment for veterans) with the Kurtzke Expanded Disability Status Scale (EDSS) and the Functional System (FS) scales, which are standard MS disability scales. EDSS and FS scores were significantly correlated with some VSF-36 domains (physical function [r = - 0.57], role physical [r = - 0.37], and physical component summary [r = - 0.40]) and weakly correlated with other domains. HRQOL scores did not predict disability or compliance with therapy. We observed decrements in HRQOL at relatively low disability levels. HRQOL measures directly associated with physical function were correlated with standard MS disability scales. Researchers need to clarify the role of HRQOL in clinical outcomes assessment, as shown by the lack of outcome sensitivity and predictive value of the VSF-36.
Key words: clinical outcome assessment, disability, disease- modifying agents, Expanded Disability Status Scale, functional status, Functional System scales, health-related quality of life, multiple sclerosis, outcome sensitivity, Veterans Short-Form 36.

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