diff --git a/.gitignore b/.gitignore index 4f9c622..b9459b5 100644 --- a/.gitignore +++ b/.gitignore @@ -1,25 +1,88 @@ -# 1. Broad Ignores -/Data/* -/attach/* -/results/* -/enarcelona/* -.env +# ========================= +# Python +# ========================= __pycache__/ -*.pyc -*.csv -======= -/reference/ -*.svg -**/*.csv -**/*.json* -**/*.txt* -**/*.png* -*.log ->>>>>>> Stashed changes -# 2. Ignore virtual environments COMPLETELY -# This must come BEFORE the unignore rule -env*/ +*.py[cod] +*$py.class +.ipynb_checkpoints/ -# 3. The "Unignore" rule (Whitelisting) -# We only unignore .py files that aren't already blocked by the rules above -!**/*.py +# ========================= +# Virtual environments +# ========================= +env/ +env*/ +venv/ +.venv/ +enarcelona/ + +# ========================= +# Secrets +# ========================= +.env +*.env + +# ========================= +# Patient data / sensitive data +# ========================= +Data/ +data/raw/ +data/processed/ +data/ground_truth/ +reference/ + +# ========================= +# Generated results and logs +# ========================= +results/ +results_edss_benchmark/ +*.log + +# ========================= +# Large/generated file types +# ========================= +*.csv +*.tsv +*.json +*.jsonl +*.xlsx +*.xls +*.png +*.PNG +*.jpg +*.jpeg +*.svg +*.pdf + +# ========================= +# Temporary / backup files +# ========================= +*.tmp +*.bak +*.orig +.DS_Store + +# ========================= +# Keep important code/config/docs +# ========================= +!README.md +!requirements.txt +!*.py +!*.md +!*.yml +!*.yaml +!*.toml + +# Keep prompt templates / schemas if safe to publish +!prompts/ +!prompts/** +!attach/ +!attach/*.gbnf +!attach/just_edss_text.txt +!attach/Komplett.txt + +# Keep example/synthetic data only +!data/ +!data/example/ +!data/example/** +!Data/example/ +!Data/example/** diff --git a/attach/Komplett.txt b/attach/Komplett.txt new file mode 100644 index 0000000..8759314 --- /dev/null +++ b/attach/Komplett.txt @@ -0,0 +1,481 @@ +1 VISUAL OPTIC FUNCTIONS + +VISUAL ACUITY +The visual acuity score is based on the line in the Snellen chart at 20 feet 5 meters +for which the patient makes no more than one error using best available correction +Alternatively best corrected near vision can be assessed but this should be noted and +consistently performed during follow up examinations Switching from near to distance +visual acuity measurements should be avoided in follow up examinations + +VISUAL FIELDS +0 normal +1 signs only deficits present only on formal confrontational testing +2 moderate patient aware of deficit but incomplete hemianopsia on examination +3 marked complete homonymous hemianopsia or equivalent + +SCOTOMA +0 none +1 small detectable only on formal confrontational testing +2 large spontaneously reported by patient + +* DISC PALLOR +0 not present +1 present + +NOTE +When determining the EDSS step the Visual FS score must be converted to a lower +score as follows +Visual FS Score 6 5 4 3 2 1 +Converted Visual FS Score 4 3 3 2 2 1 + +FUNCTIONAL SYSTEM SCORE +0 normal +1 disc pallor and or small scotoma and or visual acuity corrected of worse eye less than 20 20 1.0 but better than 20 30 0.67 +2 worse eye with maximal visual acuity corrected of 20 30 to 20 59 0.67 – 0.34 +3 worse eye with large scotoma and or moderate decrease in fields and or maximal visual acuity corrected of 20 60 to 20 99 0.33 – 0.21 +4 worse eye with marked decrease of fields and or maximal visual acuity corrected of 20 100 to 20 200 0.2 – 0.1 grade 3 plus maximal acuity of better eye of 20 60 0.33 or less +5 worse eye with maximal visual acuity corrected less than 20 200 0.1 grade 4 plus maximal acuity of better eye of 20 60 0.33 or less +6 grade 5 plus maximal acuity of better eye of 20 60 0.33 or less * = optional part of the examination + + +### BRAINSTEM FUNCTIONS + +**DYSARTHRIA** +- **0**: None +- **1**: Signs only +- **2**: Mild: Clinically detectable, patient is aware +- **3**: Moderate: Obvious during conversation, impairs comprehension +- **4**: Marked: Incomprehensible speech +- **5**: Inability to speak + +**DYSPHAGIA** +- **0**: None +- **1**: Signs only +- **2**: Mild: Difficulty with thin liquids +- **3**: Moderate: Difficulty with liquids and solid food +- **4**: Marked: Sustained difficulty, requires pureed diet +- **5**: Inability to swallow + +**OTHER CRANIAL NERVE FUNCTIONS** +- **0**: Normal +- **1**: Signs only +- **2**: Mild disability: Clinically detectable deficit, patient is usually aware +- **3**: Moderate disability +- **4**: Marked disability + +**EXTRAOCULAR MOVEMENTS (EOM) IMPAIRMENT** +- **0**: None +- **1**: Signs only: Subtle EOM weakness, no complaints of vision issues +- **2**: Mild: Subtle EOM weakness or obvious incomplete paralysis not noticed by patient +- **3**: Moderate: Obvious incomplete paralysis noticed by patient or complete loss in one direction +- **4**: Marked: Complete loss in more than one direction + +**NYSTAGMUS** +- **0**: None +- **1**: Signs only or mild: Gaze-evoked nystagmus below moderate limits (equivalent to Brainstem FS score of 1) +- **2**: Moderate: Sustained nystagmus on horizontal/vertical gaze at 30 degrees, patient may not notice +- **3**: Severe: Nystagmus in primary position or coarse persistent nystagmus interfering with vision; complete internuclear ophthalmoplegia; oscillopsia + +**TRIGEMINAL DAMAGE** +- **0**: None +- **1**: Signs only +- **2**: Mild: Clinically detectable numbness, patient is aware +- **3**: Moderate: Impaired sharp/dull discrimination in one to three branches or trigeminal neuralgia (at least one recent attack) +- **4**: Marked: Unable to discriminate between sharp/dull or complete loss of sensation in one or both nerves + +**FACIAL WEAKNESS** +- **0**: None +- **1**: Signs only +- **2**: Mild: Clinically detectable weakness, patient is aware +- **3**: Moderate: Incomplete facial palsy (e.g., eye closure requires patching, drooling) +- **4**: Marked: Complete unilateral or bilateral facial palsy with lagophthalmus or difficulty with liquids + +**HEARING LOSS** +- **0**: None +- **1**: Signs only: Hears finger rub less on one/both sides, lateralized Weber test but no complaints +- **2**: Mild: As in 1, aware of hearing problem +- **3**: Moderate: Does not hear finger rub on one/both sides, misses several whispered numbers +- **4**: Marked: Misses all or nearly all whispered numbers + +**FUNCTIONAL SYSTEM SCORE** +- **0**: Normal +- **1**: Signs only +- **2**: Moderate nystagmus/EOM impairment/other mild disability +- **3**: Severe nystagmus/marked EOM impairment/moderate other cranial nerve disability +- **4**: Marked dysarthria/other marked disability +- **5**: Inability to swallow or speak + +### PYRAMIDAL FUNCTIONS + +#### REFLEXES +- **0**: Absent +- **1**: Diminished +- **2**: Normal +- **3**: Exaggerated +- **4**: Nonsustained clonus (a few beats of clonus) +- **5**: Sustained clonus + +##### Cutaneous Reflexes +- **0**: Normal +- **1**: Weak +- **2**: Absent + +###### Palmomental Reflex +- **0**: Absent +- **1**: Present + +###### Plantar Response +- **0**: Flexor +- **1**: Neutral or equivocal +- **2**: Extensor + +#### LIMB STRENGTH +The weakest muscle in each group defines the score for that muscle group. Optional functional tests (hopping on one foot and walking on heels/toes) are recommended for BMRC grades 3–5. + +##### BMRC Rating Scale +- **0**: No muscle contraction detected +- **1**: Visible contraction without visible joint movement +- **2**: Visible movement only on the plane of gravity +- **3**: Active movement against gravity, but not against resistance +- **4**: Active movement against resistance, but not full strength +- **5**: Normal strength + +#### FUNCTIONAL TESTS +##### Pronator Drift (Upper Extremities) +Pronation and downward drift: +- **0**: None +- **1**: Mild +- **2**: Evident + +##### Position Test (Lower Extremities) +Ask patient to lift both legs together, with legs fully extended at the knee. Sinking: +- **0**: None +- **1**: Mild +- **2**: Evident +- **3**: Able to lift only one leg at a time (grade from the horizontal position at the hip joints in degrees) +- **4**: Unable to lift one leg at a time + +##### Walking on Heels/Toes +- **0**: Normal +- **1**: Impaired +- **2**: Not possible + +##### Hopping on One Foot +- **0**: Normal +- **1**: 6–10 times +- **2**: 1–5 times +- **3**: Not possible + +#### LIMB SPASTICITY (AFTER RAPID FLEXION OF THE EXTREMITY) +- **0**: None +- **1**: Mild: barely increased muscle tone +- **2**: Moderate: moderately increased muscle tone that can be overcome; full range of motion is possible +- **3**: Severe: severely increased muscle tone that is extremely difficult to overcome; full range of motion is not possible +- **4**: Contracted + +#### GAIT SPASTICITY +- **0**: None +- **1**: Barely perceptible +- **2**: Evident: minor interference with function +- **3**: Permanent shuffling: major interference with function + +#### OVERALL MOTOR PERFORMANCE +- **0**: Normal +- **1**: Abnormal weakness (as compared to peers) in performing more demanding tasks, e.g., walking longer distances; no reduction in limb strength on formal testing +- **2**: Reduction in strength of individual muscle groups at confrontational testing + +#### FUNCTIONAL SYSTEM SCORE +- **0**: Normal +- **1**: Abnormal signs without disability +- **2**: Minimal disability: patient complains of motor-fatigability or reduced performance in strenuous motor tasks (motor performance grade 1) and/or BMRC grade 4 in one or two muscle groups +- **3**: Mild to moderate paraparesis or hemiparesis: usually BMRC grade 4 in more than two muscle groups; and/or BMRC grade 3 in one or two muscle groups (movements against gravity +are possible); and/or severe monoparesis: BMRC grade 2 or less in one muscle group +- **4**: Marked paraparesis or hemiparesis: usually BMRC grade 2 in two limbs or monoplegia with BMRC grade 0 or 1 in one limb; and/or moderate tetraparesis: BMRC grade 3 in three or more limbs +- **5**: Paraplegia: BMRC grade 0 or 1 in all muscle groups of the lower limbs; and/or marked tetraparesis: BMRC grade 2 or less in three or more limbs; and/or hemiplegia +- **6**: Tetraplegia: BMRC grade 0 or 1 in all muscle groups of the upper and lower limbs + +### CEREBELLAR FUNCTIONS + +#### HEAD TREMOR +- **0**: none +- **1**: mild +- **2**: moderate +- **3**: severe + +#### TRUNCAL ATAXIA +- **0**: none +- **1**: signs only +- **2**: mild (swaying with eyes closed) +- **3**: moderate (swaying with eyes open) +- **4**: severe (unable to sit without assistance) + +#### LIMB ATAXIA (TREMOR / DYSMETRIA AND RAPID ALTERNATING MOVEMENTS) +- **0**: none +- **1**: signs only +- **2**: mild (tremor or clumsy movements easily seen, minor interference with function) +- **3**: moderate (tremor or clumsy movements interfere with function in all spheres) +- **4**: severe (most functions are very difficult) + +#### TANDEM (STRAIGHT LINE) WALKING +- **0**: normal +- **1**: impaired +- **2**: not possible + +#### GAIT ATAXIA +- **0**: none +- **1**: signs only +- **2**: mild (problems with balance realized by patient and/or significant other) +- **3**: moderate (abnormal balance with ordinary walking) +- **4**: severe (unable to walk more than a few steps unassisted or requires a walking aid or assistance due to ataxia) + +#### ROMBERG TEST +- **0**: normal +- **1**: mild (mild instability with eyes closed) +- **2**: moderate (not stable with eyes closed) +- **3**: severe (not stable with eyes open) + +#### OTHER CEREBELLAR TESTS +- **0**: normal +- **1**: mild abnormality +- **2**: moderate abnormality +- **3**: severe abnormality + +**NOTE:** +- The presence of severe gait and/or truncal ataxia alone (without severe ataxia in three or four limbs) results in a Cerebellar FS score of 3. +- If weakness or sensory deficits interfere with the testing of ataxia, score the patient’s actual performance. Indicate the possible role of weakness by marking an "X" after the +affected subsystems and Cerebellar FS score. + +#### FUNCTIONAL SYSTEM SCORE +- **0**: normal +- **1**: abnormal signs without disability +- **2**: mild ataxia and/or moderate station ataxia (Romberg) and/or tandem walking not possible +- **3**: moderate limb ataxia and/or moderate or severe gait/truncal ataxia +- **4**: severe gait/truncal ataxia and severe ataxia in three or four limbs +- **5**: unable to perform coordinated movements due to ataxia +- **X**: pyramidal weakness (BMRC grade 3 or worse in limb strength) or sensory deficits interfere with cerebellar testing + +### SENSORY FUNCTIONS + +#### SUPERFICIAL SENSATION (LIGHT TOUCH AND PAIN) +- **0**: normal +- **1**: signs only (slightly diminished sensation on formal testing, patient not aware) +- **2**: mild (patient aware of impaired light touch or pain but can discriminate sharp/dull) +- **3**: moderate (impaired discrimination of sharp/dull) +- **4**: marked (unable to discriminate between sharp/dull and/or unable to feel light touch) +- **5**: complete loss (anesthesia) + +#### VIBRATION SENSE (AT THE MOST DISTAL JOINT) +- **0**: normal +- **1**: mild (graded tuning fork 5–7 of 8; detects more than 10 seconds but less than examiner) +- **2**: moderate (graded tuning fork 1–4 of 8; detects between 2 and 10 sec.) +- **3**: marked (complete loss of vibration sense) + +#### POSITION SENSE +- **0**: normal +- **1**: mild (1–2 incorrect responses, only distal joints affected) +- **2**: moderate (misses many movements of fingers or toes; proximal joints affected) +- **3**: marked (no perception of movement, astasia) + +* **LHERMITTE’S SIGN** (does not contribute to the Sensory FS score) + - **0**: negative + - **1**: positive + +* **PARAESTHESIAE (TINGLING)** (does not contribute to the Sensory FS score) + - **0**: none + - **1**: present + +#### FUNCTIONAL SYSTEM SCORE +- **0**: normal +- **1**: impaired superficial sensation in one or two limbs +- **2**: mild impairment in more than two limbs, no major proprioceptive deficits +- **3**: moderate impairment in more than two limbs with minor proprioceptive deficits +- **4**: severe impairment in more than two limbs with significant proprioceptive deficits +- **5**: loss of sensation in one or two limbs, significant proprioceptive deficits in most of the body below the head +- **6**: essentially no sensation below the head + +### BOWEL AND BLADDER FUNCTIONS + +#### URINARY HESITANCY AND RETENTION +- **0**: none +- **1**: mild (no major impact on lifestyle) +- **2**: moderate (urinary retention; frequent urinary tract infections) +- **3**: severe (requires catheterization) +- **4**: loss of function (overflow incontinence) + +#### URINARY URGENCY AND INCONTINENCE +- **0**: none +- **1**: mild (no major impact on lifestyle) +- **2**: moderate (rare incontinence occurring no more than once a week; must wear pads) +- **3**: severe (frequent incontinence occurring from several times a week to more than once a day; must wear urinal or pads) +- **4**: loss of function (loss of bladder control) + +#### BLADDER CATHETERIZATION +- **0**: none +- **1**: intermittent self-catheterization +- **2**: constant catheterization + +#### BOWEL DYSFUNCTION +- **0**: none +- **1**: mild (no incontinence, no major impact on lifestyle, mild constipation) +- **2**: moderate (must wear pads or alter lifestyle to be near lavatory) +- **3**: severe (in need of enemas or manual measures to evacuate bowels) +- **4**: complete loss of function + +#### SEXUAL DYSFUNCTION +**Male** +- **0**: none +- **1**: mild (difficulty maintaining erection during intercourse, but achieves erection and still has intercourse) +- **2**: moderate (difficulty achieving erection, decreased libido, still has intercourse and reaches orgasm) +- **3**: severe (marked decrease in libido, inability to achieve full erection, intercourse with difficulty, hypoorgasmia) +- **4**: loss of function + +**Female** +- **0**: none +- **1**: mild (mild lack of lubrication, still sexually active and reaches orgasm) +- **2**: moderate (dyspareunia, hypoorgasmia, decrease in sexual activity) +- **3**: severe (marked decrease in sexual activity, anorgasmia) +- **4**: loss of function + +**NOTE** +When determining the EDSS step, the Bowel and Bladder FS score must be converted to a lower score as follows: +- Bowel and Bladder FS Score: 6 → Converted Bowel and Bladder FS Score: 5 +- Bowel and Bladder FS Score: 5 → Converted Bowel and Bladder FS Score: 4 +- Bowel and Bladder FS Score: 4 → Converted Bowel and Bladder FS Score: 3 +- Bowel and Bladder FS Score: 3 → Converted Bowel and Bladder FS Score: 3 +- Bowel and Bladder FS Score: 2 → Converted Bowel and Bladder FS Score: 2 +- Bowel and Bladder FS Score: 1 → Converted Bowel and Bladder FS Score: 1 + +Sexual dysfunction can be documented but generally does not impact the FS score due to assessment difficulties by examining physicians. + +### FUNCTIONAL SYSTEM SCORE +- **0**: normal +- **1**: mild urinary hesitancy, urgency, and/or constipation +- **2**: moderate urinary hesitancy/retention and/or moderate urinary urgency/incontinence and/or moderate bowel dysfunction +- **3**: frequent urinary incontinence or intermittent self-catheterization; needs enemas or manual measures to evacuate bowels +- **4**: in need of almost constant catheterization +- **5**: loss of bladder or bowel function (external or indwelling catheter) +- **6**: loss of bowel and bladder function + +### CEREBRAL FUNCTIONS + +#### DEPRESSION AND EUPHORIA +- **0**: none +- **1**: present (Patient complains of depression or is considered depressed or euphoric by the investigator or significant other.) + +**Note**: Depression and Euphoria are documented on the scoring sheet but are not taken into consideration for FS and EDSS calculation. + +#### DECREASE IN MENTATION +- **0**: none +- **1**: signs only (not apparent to patient and/or significant other) +- **2**: mild (Patient and/or significant other report mild changes in mentation. Examples include: impaired ability to follow a rapid course of association or survey complex matters; +impaired judgment in certain demanding situations; capable of handling routine daily activities, but unable to tolerate additional stressors; intermittently symptomatic even with +normal levels of stress; reduced performance; tendency toward negligence due to obliviousness or fatigue.) +- **3**: moderate (Definite abnormalities on brief mental status testing, but still oriented to person, place, and time) +- **4**: marked (Not oriented in one or two spheres (person, place, or time); marked effect on lifestyle) +- **5**: dementia, confusion, and/or complete disorientation + +#### FATIGUE +- **0**: none +- **1**: mild (Does not usually interfere with daily activities) +- **2**: moderate (Interferes but does not limit daily activities for more than 50%) +- **3**: severe (Significant limitation in daily activities (> 50% reduction)) + +**Note**: Because fatigue is difficult to evaluate objectively, in some studies it does not contribute to the Cerebral FS score or EDSS step. Please adhere to the study’s specific +instructions. + +### FUNCTIONAL SYSTEM SCORE +- **0**: normal +- **1**: signs only in decrease in mentation; mild fatigue +- **2**: mild decrease in mentation; moderate or severe fatigue +- **3**: moderate decrease in mentation +- **4**: marked decrease in mentation +- **5**: dementia + +### AMBULATION + +**Unrestricted Ambulation** +- The patient can walk a normal distance without assistance, comparable to healthy individuals of similar age and physical condition. +- EDSS step can range from 0 to 5.0, depending on the Functional System (FS) scores. + +**Fully Ambulatory** +- At least 500 meters of ambulation without assistance, but not unrestricted. +- EDSS step can range from 2.0 to 5.0, depending on FS scores. +- The Pyramidal and/or Cerebellar FS must be ≥ 2 to reflect this restriction in ambulation. + +**Ambulation < 500 Meters** +- If the walking distance is less than 500 meters, the EDSS step must be ≥ 4.5, depending on the walking ranges provided by the ambulation score and combination of FS scores. +- EDSS steps 5.5 to 8.0 are exclusively defined by the ability to ambulate and type of assistance required, or the ability to use a wheelchair. + +**Assistance Needed** +- Definitions for EDSS steps 6.0 or 6.5 include both the type of assistance required when walking and the walking range. +- Assistance by another person is equivalent to bilateral assistance. + +**Note:** +- The ambulation score represents both the walking range and the type of assistance required. +- This score replaces several checkboxes used previously on the scoring sheet but does not introduce new definitions. +- Use of a wheelchair can now be scored on the scoring sheet. +- Indicate the reported distance and time for the patient in the appropriate field on the scoring sheet, followed by the type of assistance and walking distance measured during assessment. + + +### DISTANCE AND TIME REPORTED BY PATIENT + +**Maximal Unassisted Walking Distance** +- Maximal unassisted walking distance reported by the patient (in meters) without rest or assistance. +- Time required to walk the maximum distance according to the patient (in minutes). + +**Assistance** +0. Without help or assistance (allowing use of an ankle-foot orthotic device, but no other assistive devices). +1. Unilateral assistance: one stick/crutch/brace. +2. Bilateral assistance: two sticks/crutches/braces or assistance by another person. +3. Wheelchair. + +**Distance** +- Measure the distance the patient can walk in meters. + - **Unassisted:** Observe walking for a minimum of 500 meters and measure time needed, if possible. + - **Assisted:** Observe walking with assistive devices or help from another person for a minimum of 130 meters, if possible. + +--- + +### AMBULATION SCORE + +0. Unrestricted +1. Fully ambulatory +2. ≥ 300 meters but < 500 meters, without help or assistance (EDSS 4.5 or 5.0) +3. ≥ 200 meters but < 300 meters, without help or assistance (EDSS 5.0) +4. ≥ 100 meters but < 200 meters, without help or assistance (EDSS 5.5) +5. Walking range < 100 meters without assistance (EDSS 6.0) +6. Unilateral assistance, ≥ 50 meters (EDSS 6.0) +7. Bilateral assistance, ≥ 120 meters (EDSS 6.0) +8. Unilateral assistance, < 50 meters (EDSS 6.5) +9. Bilateral assistance, ≥ 5 meters but < 120 meters (EDSS 6.5) +10. Uses wheelchair without help; unable to walk 5 meters even with aid, essentially restricted to wheelchair; wheels self and transfers alone; up and about in wheelchair for some 12 hours a day (EDSS 7.0) +11. Uses wheelchair with help; unable to take more than a few steps; restricted to wheelchair; may need some help in transferring and wheeling self (EDSS 7.5) +12. Essentially restricted to bed or chair or perambulated in wheelchair, but out of bed most of the day; retains many self-care functions; generally has effective use of arms (EDSS 8.0) + +Expanded Disability Status Scale (EDSS) + +0 - Normal neurological exam (all Functional Systems [FS] grade 0) +1.0 - No disability, minimal signs in one FS (one FS grade 1) +1.5 - No disability, minimal signs in more than one FS (more than one FS grade 1) +2.0 - Minimal disability in one FS (one FS grade 2, others 0 or 1) +2.5 - Minimal disability in two FS (two FS grades 2, others 0 or 1) +3.0 - Moderate disability in one FS (one FS grade 3, others 0 or 1) though fully ambulatory; +or mild disability in three or four FS (three/four FS grades 2, others 0 or 1) though fully ambulatory +3.5 - Fully ambulatory but with moderate disability in one FS (one FS grade 3) and mild disability in one or two FS (one/two FS grade 2) and others 0 or 1; +or fully ambulatory with two FS grades 3 (others 0 or 1); +or fully ambulatory with five FS grades 2 (others 0 or 1) +4.0 - Unable to walk > 25 feet without aid +4.5 - Unable to walk > 100 feet without aid +5.0 - Relies on a walking aid; unable to walk > 300 feet without resting +5.5 - Relies on a walking aid; unable to walk > 200 feet without resting +6.0 - Unable to walk more than 50 feet with or without aid; cannot stand unaided for five minutes +6.5 - Unable to walk more than 10 feet with or without aid; cannot stand unaided for two minutes +7.0 - Unable to walk 5 meters even with aid, essentially restricted to wheelchair; wheels self and transfers alone; up and about in wheelchair some 12 hours a day +7.5 - Unable to take more than a few steps; restricted to wheelchair; may need some help in transferring and in wheeling self +8.0 - Essentially restricted to bed or chair or perambulated in wheelchair, but out of bed most of the day; retains many self-care functions; generally has effective use of arms +8.5 - Essentially restricted to bed much of the day; has some effective use of arm(s); retains some self-care functions +9.0 - Helpless bed patient; can communicate and eat +9.5 - Totally helpless bed patient; unable to communicate effectively or eat/swallow +10 - Death due to MS + + diff --git a/attach/just_edss_schema.gbnf b/attach/just_edss_schema.gbnf new file mode 100644 index 0000000..2ff8856 --- /dev/null +++ b/attach/just_edss_schema.gbnf @@ -0,0 +1,11 @@ +EDSS-kv ::= "\"EDSS\"" space ":" space number +Reason ::= "\"" char{0,400} "\"" space +Reason-kv ::= "\"Reason\"" space ":" space Reason +boolean ::= ("true" | "false") space +char ::= [^"\\\x7F\x00-\x1F] | [\\] (["\\bfnrt] | "u" [0-9a-fA-F]{4}) +decimal-part ::= [0-9]{1,16} +integral-part ::= [0] | [1-9] [0-9]{0,15} +nicht-klassifizierbar-kv ::= "\"nicht_klassifizierbar\"" space ":" space boolean +number ::= ("-"? integral-part) ("." decimal-part)? ([eE] [-+]? integral-part)? space +root ::= "{" space Reason-kv "," space nicht-klassifizierbar-kv ( "," space ( EDSS-kv ) )? "}" space +space ::= | " " | "\n"{1,2} [ \t]{0,20} diff --git a/attach/just_edss_text.txt b/attach/just_edss_text.txt new file mode 100644 index 0000000..c759557 --- /dev/null +++ b/attach/just_edss_text.txt @@ -0,0 +1,25 @@ +Expanded Disability Status Scale (EDSS) + +0 - Normal neurological exam (all Functional Systems [FS] grade 0) +1.0 - No disability, minimal signs in one FS (one FS grade 1) +1.5 - No disability, minimal signs in more than one FS (more than one FS grade 1) +2.0 - Minimal disability in one FS (one FS grade 2, others 0 or 1) +2.5 - Minimal disability in two FS (two FS grades 2, others 0 or 1) +3.0 - Moderate disability in one FS (one FS grade 3, others 0 or 1) though fully ambulatory; +or mild disability in three or four FS (three/four FS grades 2, others 0 or 1) though fully ambulatory +3.5 - Fully ambulatory but with moderate disability in one FS (one FS grade 3) and mild disability in one or two FS (one/two FS grade 2) and others 0 or 1; +or fully ambulatory with two FS grades 3 (others 0 or 1); +or fully ambulatory with five FS grades 2 (others 0 or 1) +4.0 - Unable to walk > 25 feet without aid +4.5 - Unable to walk > 100 feet without aid +5.0 - Relies on a walking aid; unable to walk > 300 feet without resting +5.5 - Relies on a walking aid; unable to walk > 200 feet without resting +6.0 - Unable to walk more than 50 feet with or without aid; cannot stand unaided for five minutes +6.5 - Unable to walk more than 10 feet with or without aid; cannot stand unaided for two minutes +7.0 - Unable to walk 5 meters even with aid, essentially restricted to wheelchair; wheels self and transfers alone; up and about in wheelchair some 12 hours a day +7.5 - Unable to take more than a few steps; restricted to wheelchair; may need some help in transferring and in wheeling self +8.0 - Essentially restricted to bed or chair or perambulated in wheelchair, but out of bed most of the day; retains many self-care functions; generally has effective use of arms +8.5 - Essentially restricted to bed much of the day; has some effective use of arm(s); retains some self-care functions +9.0 - Helpless bed patient; can communicate and eat +9.5 - Totally helpless bed patient; unable to communicate effectively or eat/swallow +10 - Death due to MS \ No newline at end of file