{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T15:17:17Z","timestamp":1788362237491,"version":"build-2803163510"},"reference-count":69,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health, Current Research Funds 2026","award":["RRC-2026-23688274"],"award-info":[{"award-number":["RRC-2026-23688274"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Med. Sci.","Medical Sciences"],"abstract":"<jats:p>Background\/Objectives: Multiple sclerosis (MS) affects motor, cognitive, psychological, and social functioning that impairment-based scales do not fully capture. This systematic review evaluated the measurement properties and applications of the World Health Organization Disability Assessment Schedule (WHODAS) 2.0 in adults with MS across research and clinical contexts. Methods: PubMed\/MEDLINE, Embase, Scopus, Web of Science, and the Cochrane Library were searched from inception to 25 May 2026. Eligible peer-reviewed studies reported extractable WHODAS data in adults with MS. Evidence was organized into measurement, clinical-association, participation\/employment, intervention, digital-monitoring, and longitudinal streams. Design-appropriate critical-appraisal tools and outcome-specific certainty assessments were applied; quantitative pooling was assessed but was not justified. Results: Of the 677 records identified, 28 reports were included. Five reports evaluated measurement properties; moderate-certainty evidence supported reliability and construct validity, although precision differed among 12-, 32-, and 36-item forms. Associations with quality of life and clinical severity were supported by low-certainty evidence. Evidence concerning fatigue, mood, cognition, participation, and employment was of low or very low certainty because most studies were cross-sectional, used heterogeneous metrics, or involved overlapping cohorts. Intervention evidence was of very low to low certainty: WHODAS was secondary, and interventions, time points, and scoring methods were not comparable. Eight reports arose from one overlapping research program. Conclusions: WHODAS 2.0 provides a multidimensional patient-reported account of functioning in MS and may complement, but not replace, the Expanded Disability Status Scale. Evidence supports measurement use more strongly than prognostic, treatment-response, or benefit-determination claims. Standardized version selection, scoring, domain reporting, and prespecified longitudinal endpoints are required.<\/jats:p>","DOI":"10.3390\/medsci14050542","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T14:35:29Z","timestamp":1788359729000},"page":"542","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Measurement Properties and Applications of WHODAS 2.0 in Multiple Sclerosis: A Systematic Review"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6229-6463","authenticated-orcid":false,"given":"Amelia","family":"Rizzo","sequence":"first","affiliation":[{"name":"Medico-Legal Centre of Messina, National Institute of Social Welfare (INPS), Via Giuseppe Garibaldi 124, 98122 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0757-2389","authenticated-orcid":false,"given":"Maria Grazia","family":"Maggio","sequence":"additional","affiliation":[{"name":"IRCCS Centro Neurolesi Bonino Pulejo, S.S. 113, Via Palermo, Contrada Casazza, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Calderone","sequence":"additional","affiliation":[{"name":"IRCCS Centro Neurolesi Bonino Pulejo, S.S. 113, Via Palermo, Contrada Casazza, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1348-9442","authenticated-orcid":false,"given":"Federica","family":"Impellizzeri","sequence":"additional","affiliation":[{"name":"IRCCS Centro Neurolesi Bonino Pulejo, S.S. 113, Via Palermo, Contrada Casazza, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Pistorino","sequence":"additional","affiliation":[{"name":"Department of Brain and Behavioral Sciences, University of Pavia, Via Agostino Bassi 21, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Pitrone","sequence":"additional","affiliation":[{"name":"Medico-Legal Centre of Messina, National Institute of Social Welfare (INPS), Via Giuseppe Garibaldi 124, 98122 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aldo","family":"Sitibondo","sequence":"additional","affiliation":[{"name":"Medico-Legal Centre of Messina, National Institute of Social Welfare (INPS), Via Giuseppe Garibaldi 124, 98122 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Meus","sequence":"additional","affiliation":[{"name":"Medico-Legal Centre of Genova, National Institute of Social Welfare (INPS), Piazza della Vittoria 6R, 16121 Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Mazziotti","sequence":"additional","affiliation":[{"name":"Medico-Legal General Coordination, National Institute of Social Welfare (INPS), Via Ciro il Grande, 21, 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"Migliorini","sequence":"additional","affiliation":[{"name":"Medico-Legal General Coordination, National Institute of Social Welfare (INPS), Via Ciro il Grande, 21, 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Burzomati","sequence":"additional","affiliation":[{"name":"Medico-Legal Centre of Messina, National Institute of Social Welfare (INPS), Via Giuseppe Garibaldi 124, 98122 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8566-3166","authenticated-orcid":false,"given":"Rocco Salvatore","family":"Calabr\u00f2","sequence":"additional","affiliation":[{"name":"IRCCS Centro Neurolesi Bonino Pulejo, S.S. 113, Via Palermo, Contrada Casazza, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1816","DOI":"10.1177\/1352458520970841","article-title":"Rising prevalence of multiple sclerosis worldwide: Insights from the Atlas of MS, third edition","volume":"26","author":"Walton","year":"2020","journal-title":"Mult. Scler."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/S0140-6736(23)01473-3","article-title":"Multiple sclerosis","volume":"403","author":"Jakimovski","year":"2024","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/S1474-4422(17)30470-2","article-title":"Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria","volume":"17","author":"Thompson","year":"2018","journal-title":"Lancet Neurol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1212\/WNL.0000000000000560","article-title":"Defining the clinical course of multiple sclerosis: The 2013 revisions","volume":"83","author":"Lublin","year":"2014","journal-title":"Neurology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1444","DOI":"10.1212\/WNL.33.11.1444","article-title":"Rating neurologic impairment in multiple sclerosis: An expanded disability status scale (EDSS)","volume":"33","author":"Kurtzke","year":"1983","journal-title":"Neurology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1038\/s41582-024-01006-1","article-title":"Assessing disease progression and treatment response in progressive multiple sclerosis","volume":"20","author":"Comi","year":"2024","journal-title":"Nat. Rev. Neurol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"105501","DOI":"10.1016\/j.msard.2024.105501","article-title":"Defining a standard set of health outcomes for patients with relapsing-remitting multiple sclerosis","volume":"84","author":"Rovira","year":"2024","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"jrm19671","DOI":"10.2340\/jrm.v56.19671","article-title":"Revision of the brief international classification of functioning, disability and health core set for multiple sclerosis: A study of the comprehensive icf core set for multiple sclerosis with participants referred for work ability assessment","volume":"56","year":"2024","journal-title":"J. Rehabil. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"815","DOI":"10.2471\/BLT.09.067231","article-title":"Developing the World Health Organization Disability Assessment Schedule 2.0","volume":"88","author":"Chatterji","year":"2010","journal-title":"Bull. World Health Organ."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2347","DOI":"10.1080\/09638288.2016.1223177","article-title":"World Health Organization disability assessment schedule 2.0: An international systematic review","volume":"39","author":"Federici","year":"2017","journal-title":"Disabil. Rehabil."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Nasirzadeh, A., Mohammadi, M., Bafrani, M.A., Mohammadi, A., and Bakhtiari-Dovvombaygi, H. (2024). Comparing cognitive impairment using MACFIMS in patients with multiple sclerosis and healthy controls: A systematic review and meta-analysis. BMC Neurol., 24.","DOI":"10.1186\/s12883-024-03943-2"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1007\/s00702-024-02792-0","article-title":"Depression and anxiety in multiple sclerosis. Review of a fatal combination","volume":"131","author":"Jellinger","year":"2024","journal-title":"J. Neural. Transm."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Yi, X., Zhang, Y., Du, Q., Kang, J., Song, S., Li, T., and Jiang, Y. (2024). Global prevalence of fatigue in patients with multiple sclerosis: A systematic review and meta-analysis. Front. Neurol., 15.","DOI":"10.3389\/fneur.2024.1457788"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"105858","DOI":"10.1016\/j.msard.2024.105858","article-title":"The efficacy of cognitive behavioural therapy for depression and anxiety in multiple sclerosis: A systematic review and meta-analysis","volume":"91","author":"Lucien","year":"2024","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"106225","DOI":"10.1016\/j.msard.2024.106225","article-title":"Tele-exercise in multiple sclerosis: Systematic review and meta-analysis of effects on fatigue, depression, and overall health","volume":"93","author":"Najafi","year":"2025","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Du, L., Xi, H., Zhang, S., Zhou, Y., Tao, X., Lv, Y., Hou, X., and Yu, L. (2024). Effects of exercise in people with multiple sclerosis: A systematic review and meta-analysis. Front. Public Health, 12.","DOI":"10.3389\/fpubh.2024.1387658"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1007\/s10926-023-10149-9","article-title":"Work Difficulties in People with Multiple Sclerosis","volume":"34","author":"Ponzio","year":"2024","journal-title":"J. Occup. Rehabil."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"105754","DOI":"10.1016\/j.msard.2024.105754","article-title":"Exploring the workplace factors and their influence on the employment outcomes for people with multiple sclerosis","volume":"88","author":"Zhao","year":"2024","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e16016","DOI":"10.1111\/ene.16016","article-title":"Changes in employment status over time in multiple sclerosis following a first episode of central nervous system demyelination, a Markov multistate model study","volume":"31","author":"Zarghami","year":"2024","journal-title":"Eur. J. Neurol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Normann, B., Arntzen, E.C., and Honan, C.A. (2024). Barriers for work in people with multiple sclerosis: A Norwegian cultural adaptation and validation of the short version of the multiple sclerosis work difficulties questionnaire. Front. Rehabil. Sci., 5.","DOI":"10.3389\/fresc.2024.1404723"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/s13643-020-01542-z","article-title":"PRISMA-S: An extension to the PRISMA Statement for Reporting Literature Searches in Systematic Reviews","volume":"10","author":"Rethlefsen","year":"2021","journal-title":"Syst. Rev."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/2046-4053-1-2","article-title":"The nuts and bolts of PROSPERO: An international prospective register of systematic reviews","volume":"1","author":"Booth","year":"2012","journal-title":"Syst. Rev."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: A revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"i4919","DOI":"10.1136\/bmj.i4919","article-title":"ROBINS-I: A tool for assessing risk of bias in non-randomised studies of interventions","volume":"355","author":"Sterne","year":"2016","journal-title":"BMJ"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1007\/s11136-017-1765-4","article-title":"COSMIN Risk of Bias checklist for systematic reviews of Patient-Reported Outcome Measures","volume":"27","author":"Mokkink","year":"2018","journal-title":"Qual. Life Res."},{"key":"ref_27","unstructured":"Aromataris, E., and Munn, Z. (2020). Systematic reviews of etiology and risk. JBI Manual for Evidence Synthesis, JBI."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"280","DOI":"10.7326\/0003-4819-158-4-201302190-00009","article-title":"Assessing bias in studies of prognostic factors","volume":"158","author":"Hayden","year":"2013","journal-title":"Ann. Intern. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1016\/j.jclinepi.2010.07.017","article-title":"GRADE guidelines: 4. Rating the quality of evidence\u2014Study limitations","volume":"64","author":"Guyatt","year":"2011","journal-title":"J. Clin. Epidemiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1136\/ebmed-2017-110668","article-title":"Rating the certainty in evidence in the absence of a single estimate of effect","volume":"22","author":"Murad","year":"2017","journal-title":"Evid. Based Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"l6890","DOI":"10.1136\/bmj.l6890","article-title":"Synthesis without meta-analysis (SWiM) in systematic reviews: Reporting guideline","volume":"368","author":"Campbell","year":"2020","journal-title":"BMJ"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1002\/acn3.50988","article-title":"Novel MS vital sign: Multi-sensor captures upper and lower limb dysfunction","volume":"7","author":"Akhbardeh","year":"2020","journal-title":"Ann. Clin. Transl. Neurol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1889","DOI":"10.1007\/s00415-021-10743-y","article-title":"Identifying falls remotely in people with multiple sclerosis","volume":"269","author":"Block","year":"2022","journal-title":"J. Neurol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2744955","DOI":"10.1155\/bn\/2744955","article-title":"Anxiety, Depression, and Expanded Disability Status Scale Independently Predict the Perception of Disability in Persons with Multiple Sclerosis: A Cross-Sectional Study","volume":"2025","author":"Curatoli","year":"2025","journal-title":"Behav. Neurol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"112367","DOI":"10.1016\/j.jpsychores.2025.112367","article-title":"Predictors of clinical response to an internet-delivered cognitive behavioural based intervention for symptoms of depression, anxiety and disability in people with multiple sclerosis","volume":"197","author":"Gandy","year":"2025","journal-title":"J. Psychosom. Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"121403","DOI":"10.1016\/j.jad.2026.121403","article-title":"A randomised controlled trial of internet-delivered cognitive behavioural therapy targeting symptoms of depression, anxiety and disability in adults with multiple sclerosis","volume":"403","author":"Gandy","year":"2026","journal-title":"J. Affect. Disord."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1186\/1477-7525-8-51","article-title":"Validation of the \u201cWorld Health Organization Disability Assessment Schedule, WHODAS-2\u201d in patients with chronic diseases","volume":"8","author":"Garin","year":"2010","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1177\/13524585241229360","article-title":"A custom-built step exergame training programme to prevent falls in people with multiple sclerosis: A multicentre randomised controlled trial","volume":"30","author":"Hoang","year":"2024","journal-title":"Mult. Scler."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Infortuna, C., Buccafusca, M., Graceffa, A.M.S., Maiorana, E., Wang, R., Ganesh, S., Yedidia, O., Bruno, A., Iannuzzo, F., and Thomas, F.P. (2025). Exploring the relationship between temperament traits, psychological symptoms, and functional disability assessed with the WHODAS 2.0 in persons with multiple sclerosis. Front. Neurol., 16.","DOI":"10.3389\/fneur.2025.1561995"},{"key":"ref_40","first-page":"2055217315592425","article-title":"Assessing clinical correlates of self-rated disability in patients with multiple sclerosis","volume":"1","author":"Magistrale","year":"2015","journal-title":"Mult. Scler. J. Exp. Transl. Clin."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1177\/1352458514543732","article-title":"Validation of the World Health Organization Disability Assessment Schedule II (WHODAS-II) in patients with multiple sclerosis","volume":"21","author":"Magistrale","year":"2015","journal-title":"Mult. Scler."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"106228","DOI":"10.1016\/j.msard.2024.106228","article-title":"Assessing disability progression using the WHODAS 2.0 in multiple sclerosis: Investigating clinical and socio-demographic factors in a large longitudinal cohort study (TONiC-MS)","volume":"93","author":"Parker","year":"2025","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"459","DOI":"10.2190\/PM.37.4.h","article-title":"Disease management for depression in an MS clinic","volume":"37","author":"Patten","year":"2007","journal-title":"Int. J. Psychiatry Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"469","DOI":"10.17219\/acem\/115237","article-title":"Social participation of patients with multiple sclerosis","volume":"29","author":"Marschollek","year":"2020","journal-title":"Adv. Clin. Exp. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1111\/ane.12387","article-title":"Development and validation of the multiple sclerosis questionnaire for the evaluation of job difficulties (MSQ-Job)","volume":"132","author":"Raggi","year":"2015","journal-title":"Acta Neurol. Scand."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Robinson, J., Dixon, J., Macsween, A., van Schaik, P., and Martin, D. (2015). The effects of exergaming on balance, gait, technology acceptance and flow experience in people with multiple sclerosis: A randomized controlled trial. BMC Sports Sci. Med. Rehabil., 7.","DOI":"10.1186\/s13102-015-0001-1"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1007\/s10880-023-09938-4","article-title":"The Association of Health Locus of Control with Clinical and Psychosocial Aspects of Living with Multiple Sclerosis","volume":"30","author":"Rothman","year":"2023","journal-title":"J. Clin. Psychol. Med. Settings"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Rothman, I., Tennant, A., Mills, R., and Young, C. (2025). Health locus of control and its relationship with quality of life and functioning in multiple sclerosis: Exploring the mediating role of self-efficacy. Sclerosis, 3.","DOI":"10.3390\/sclerosis3020010"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"215","DOI":"10.5455\/msm.2016.28.215-219","article-title":"Association between disability and quality of life in multiple sclerosis patients in Ahvaz, Iran","volume":"28","author":"Salehi","year":"2016","journal-title":"Mater. Sociomed."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"195","DOI":"10.4082\/kjfm.18.0155","article-title":"Validity and Reliability of the World Health Organization Disability Assessment Schedule 2.0 36-Item Persian Version for Persons with Multiple Sclerosis","volume":"41","author":"Salehi","year":"2020","journal-title":"Korean J. Fam. Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1007\/s10072-016-2495-z","article-title":"Multiple Sclerosis Questionnaire for Job Difficulties (MSQ-Job): Definition of the cut-off score","volume":"37","author":"Schiavolin","year":"2016","journal-title":"Neurol. Sci."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"54","DOI":"10.2478\/sjph-2019-0007","article-title":"Influence of Cognitive and Motor Abilities on the Level of Current Functioning in People with Multiple Sclerosis","volume":"58","author":"Slavkovic","year":"2019","journal-title":"Slov. J. Public Health"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"91","DOI":"10.7224\/1537-2073.2015-077","article-title":"Fatigue, Physical Activity, Quality of Life, and Fall Risk in People with Multiple Sclerosis","volume":"19","author":"Vister","year":"2017","journal-title":"Int. J. MS Care"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"185","DOI":"10.3233\/JVR-191071","article-title":"Psychometric properties of the World Health Organization Disability Assessment Schedule in people with multiple sclerosis","volume":"52","author":"Wu","year":"2020","journal-title":"J. Vocat. Rehabil."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"3235","DOI":"10.1007\/s11136-023-03470-6","article-title":"Measuring disability in multiple sclerosis: The WHODAS 2.0","volume":"32","author":"Young","year":"2023","journal-title":"Qual. Life Res."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"105648","DOI":"10.1016\/j.msard.2024.105648","article-title":"Prevalence, treatment and correlates of depression in multiple sclerosis","volume":"87","author":"Young","year":"2024","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"2181","DOI":"10.1007\/s10072-023-07155-3","article-title":"Correlates and trajectories of relapses in relapsing-remitting multiple sclerosis","volume":"45","author":"Young","year":"2024","journal-title":"Neurol. Sci."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"123409","DOI":"10.1016\/j.jns.2025.123409","article-title":"Clinical and socio-demographic characteristics of people with multiple sclerosis at the time of diagnosis: Influences on outcome trajectories","volume":"470","author":"Young","year":"2025","journal-title":"J. Neurol. Sci."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"106911","DOI":"10.1016\/j.msard.2025.106911","article-title":"Employment status in people with multiple sclerosis: Profile, dynamic changes and determinants over time","volume":"106","author":"Young","year":"2026","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"104461","DOI":"10.1016\/j.msard.2022.104461","article-title":"Development of an international, multidisciplinary, patient-centered Standard Outcome Set for Multiple Sclerosis: The S.O.S.MS project","volume":"69","author":"Daniels","year":"2023","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"104788","DOI":"10.1016\/j.msard.2023.104788","article-title":"Do clinical trials prepare to fail by failing to prepare? An examination of MS trials and recommendations for patient-reported outcome measure selection","volume":"76","author":"Hobart","year":"2023","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"104826","DOI":"10.1016\/j.msard.2023.104826","article-title":"How to measure the treatment response in progressive multiple sclerosis: Current perspectives and limitations in clinical settings\u2019","volume":"76","author":"Lorefice","year":"2023","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1709","DOI":"10.1177\/13524585231201089","article-title":"Mobile health interventions in multiple sclerosis: A systematic review","volume":"29","author":"Heesen","year":"2023","journal-title":"Mult. Scler."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"3131","DOI":"10.1007\/s00415-024-12366-5","article-title":"Clinical trial evidence of quality-of-life effects of disease-modifying therapies for multiple sclerosis: A systematic analysis","volume":"271","author":"Hirt","year":"2024","journal-title":"J. Neurol."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Zaratin, P., Samadzadeh, S., Sefero\u011flu, M., Ricigliano, V., Dos Santos Silva, J., Tunc, A., Brichetto, G., Coetzee, T., Helme, A., and Khan, U. (2024). The global patient-reported outcomes for multiple sclerosis initiative: Bridging the gap between clinical research and care\u2014updates at the 2023 plenary event. Front. Neurol., 15.","DOI":"10.3389\/fneur.2024.1407257"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1649","DOI":"10.1007\/s40120-023-00501-9","article-title":"Measuring Fatigue in Multiple Sclerosis: There may be Trouble Ahead","volume":"12","author":"Close","year":"2023","journal-title":"Neurol. Ther."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"105846","DOI":"10.1016\/j.msard.2024.105846","article-title":"A systematic literature review of the measurement of patient-reported fatigue in studies of disease modifying therapies for multiple sclerosis","volume":"91","author":"Le","year":"2024","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"106169","DOI":"10.1016\/j.msard.2024.106169","article-title":"Psychometric properties of patient-reported outcome measures, measuring fatigue in patients with multiple sclerosis, a systematic review","volume":"92","author":"Ruzzi","year":"2024","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"4179","DOI":"10.1007\/s00415-023-11801-3","article-title":"The correlation between 9-HPT and patient-reported measures of upper limb function in multiple sclerosis: A systematic review and meta-analysis","volume":"270","author":"Grange","year":"2023","journal-title":"J. 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