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To the Editor:
Nortvedt et al.1 propose a predictive value of Quality of Life (QOL) measures for future physical status in MS similar to that for cardiovascular and malignant diseases. This is an attractive idea.
However, as a progressive disease MS has different properties than cardiovascular and malignant diseases with infarction or death as well defined outcome factors. Can changes over time in the ordinal Expanded Disability Status Scale (EDSS) be compared with these endpoints? Probably not.
Nortvedt et al.1 interpret a small but significant correlation of the “mental health” subscale of the SF-36 (short form of the Health Questionnaire) with EDSS change after one year as potentially predictive. All other subscales were not significantly correlated.
In a German population of 626 patients with remitting–relapsing MS we could also compare SF-36 factors and EDSS change over one year.2 These results were similar to those obtained from the Norwegian …
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