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Criteria to Determine Disability Related to Multiple Sclerosis

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Summary (continued)

Future Research

Future research about work ability among individuals with MS can shed a great deal of light on factors that foster or hinder employment. Our full report,49 particularly the evidence reported on association of clinical findings and work ability, highlights significant evidence and information gaps concerning:

  • Patterns of MS patient reports regarding functional limitations.
  • Information commonly collected in medical encounters with MS patients (and therefore available to SSA).
  • Knowledge about the impact on performance of specific work tasks of commonly objectified parameters such as coordination, strength, and vision, and especially of factors such as fatigue or cognitive dysfunction, which are either difficult to measure or are less commonly assessed in detail.
  • Effective research methods for categorizing job or task demands in such a way as to isolate those demands that are likely to be "critical" for an SSDI applicant with MS.

In the context of these gaps, it may be productive to pursue research approaches that simultaneously address four domains:

  1. Subjective reports (this domain is not sufficient alone for SSDI determination purposes).
  2. Objective clinical data (ideally of the sort commonly encountered in medical records).
  3. In-depth objective measures (which may be available and not widely applied clinically, but which may be used with subsets of subjects to explore correlation with other domains).
  4. Work status measures (ideally longitudinal, with stratifications based on work demands).

Such an approach may apply to thermal sensitivity as well, with some additional specification and focus. Parallel assessment of concomitant ambient temperature, physical exertion, and core body temperature would address key relevant physiological exposure factors.

Outcome measures could include the domains outlined above, for example:

  • Self-perceived well-being and level of symptoms such as fatigue.
  • Clinical parameters such as walking speed or muscle strength.
  • In-depth measures such as potentially associated biomarkers or physiological parameters.
  • Work status measures, including absenteeism and disability benefits use.

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Availability of the Full Report

The full evidence report from which this summary was taken was prepared for the Agency for Healthcare Research and Quality (AHRQ) by the dukeepc.htm">Duke Evidence-based Practice Center, under Contract No. 290-02-0025. Printed copies may be obtained free of charge from the AHRQ Publications Clearinghouse by calling 800-358-9295. Requesters should ask for Evidence Report/Technology Assessment No. 100, Criteria to Determine Disability Related to Multiple Sclerosis.

The Evidence Report can also be downloaded as PDF File (5.4 MB). Plugin Software Help.

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AHRQ Publication No. 04-E019-1
Current as of May 2004


The information on this page is archived and provided for reference purposes only.


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