Table 1.
Outcome Measures
| Outcome | Measure | Scoring and Interpretation | Range |
|---|---|---|---|
| Symptom severity | SyMS (self-rated) | The SyMS assesses MS symptom severity across twelve neurologic domains. Each item is assessed on a 7-point Likert scale from 0 (not at all affected) to 6 (total limitation). Higher scores indicate more severe symptom endorsement. | 0–72 |
| Disability | EDSS | The EDSS is a measure to quantify disability in eight functional systems. It is an ordinal rating system ranging from 0 (normal) to 10 (death) in 0.5 increments interval. | 0–10 |
| Fatigue | MFIS-5 (self-rated) | The MFIS-5 assesses physical, cognitive, and psychosocial components of fatigue. Each item scores on a 5-point Likert scale from 0 (never) to 4 (almost always). Higher scores indicate more severe fatigue. | 0–20 |
| Pain | VAS (self-rated) | Visual analog scale with higher scores indicating a higher level of pain. | 0–100 |
| Mood and Anxiety | HADS (self-rated) | The HADS is a 14-item, self-assessment scale to measure symptoms of anxiety and depression. Each item is scored on a 4-point Likert scale from 0 to 3. A total subscale score >10 indicates a probable case of anxiety or depression, respectively. | 0–21 |
| Quality of life | MSIS-29 (self-rated) | The MSIS-29 measures the impact of MS on health-related quality of life. It consists of two composite domains including physical (20 items) and psychological impacts (9 items). Items are rated using a 4-point Likert scale from 1 (not at all) to 4 (extremely). Higher scores indicate greater impact. | 20–80 (physical) 9–36 (psychological) |
| Illness representations | B-IPQ (self-rated) | The B-IPQ assesses cognitive and emotional illness representations. It consists of eight items rated on a scale from 0 (minimum) to 10 (maximum). Higher scores indicate a threatening illness perception. | 0–80 |
| Stigma | SSCI-8 (self-rated) | The SSCI-8 assesses internalized and experienced stigma across neurological conditions. Each item is rated on a 5-point Likert scale from 1 (never) to 5 (always). A cut-off score >8 indicates the presence of stigmatization. | 8–40 |
| Work-related problems | MSWDQ-23 (self-rated) | The MSWDQ-23 assesses the extent of physical, psychological/cognitive, and external difficulties experienced in the workplace. Each item is scored on a 5-point Likert scale from 0 (never) to 4 (almost always). All the subscales and the total scale are scored as a percentage by summing the observed item scores, divided by the total possible item scores in each subscale, then multiplying the value by 100. Higher scores indicate greater difficulties. | 0–100 |
| Hand dexterity | 9-HPT | The 9-HPT assesses upper extremity function by measuring the time spent in placing and removing nine pegs. | Maximum of 300 seconds |
| Gait | T-25FW | The T25-FW evaluates patients’ lower extremity function by walking 25 feet. | Maximum of 180 seconds |
| Cognition | SDMT | The SDMT measures patient attention and information processing speed. A cut-off of ≤49 correct substitutions is used to identify patients with cognitive problems. | 0–110 |
| PDQ-5 (self-rated) | The PDQ-5 assesses cognitive complaints on four subscales. Each of the 5 items is scored from 0 (never) to 5 (very often). Higher scores indicate greater difficulties. | 0–5 |
Abbreviations: 9-HPT, 9-Hole Peg Test; B-IPQ, Brief Illness Perception Questionnaire; EDSS, Expanded Disability Status Scale; HADS, Hospital Anxiety and Depression Scale; MFIS-5, 5-item Modified Fatigue Impact Scale; MSIS-29, Multiple Sclerosis Impact Scale; MSWDQ-23, 23-item Multiple Sclerosis Working Difficulties Questionnaire; PDQ-5, 5-item Perceived Deficit Questionnaire; SSCI-8, Stigma Scale for Chronic Illness; SDMT, Symbol Digit Modalities Test; SyMS, SymptoMScreen; T25-FW, Timed 25-Foot Walk; VAS, Visual Analogue Scale.