WED 164 EQ-5D in the assessment of relapse recovery in ms

Rationale 50% of multiple sclerosis (MS) relapses result in permanent disability. Modelling recovery from relapse enables cost-effectiveness of interventions to be evaluated. The expanded disability status scale (EDSS) is cumbersome in clinical practice and may not reflect patient experience. The EQ-5D is a standardised measure of health status and a common currency used by agencies such as NICE. Aim To compare measurable recovery from relapse using EDSS and EQ-5D. Method EDSS and EQ-5D-3L were collected during clinician defined relapse and at 2 months follow-up, in 89 patients identified in a regional rapid access clinic. Results Median EDSS in relapse was 5.0 and 3.5 at follow-up; 67 (75%) patients experienced improvement in EDSS. The proportion of patients with EQ-5D scores of level 1 (fewest symptoms) increased in all 5 domains at 2 months, although anxiety/depression was the most resistant to improvement. Of those with EDSS improvement, only 49 (73%) reported improvement in their health state (EQ-5D). Conclusion EDSS improvement following relapse is not always accompanied by patient-reported improvement in health state (EQ-5D), which may be more effective in identifying ongoing health issues. Low-level discrepancies may also inform on the relative merit of EQ-5D versus EDSS in assessing recovery.