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Example code of atiweb/edss-in-php

Informations about the package edss-in-php

EDSS Calculator for PHP

PHP implementation of the Expanded Disability Status Scale (EDSS) calculator, based on the scoring table by Ludwig Kappos, MD (University Hospital Basel) and the Neurostatus-EDSS™ standard (Kurtzke, 1983).

This library calculates the EDSS score from 7 Functional System (FS) scores and an Ambulation score, used in the clinical assessment of Multiple Sclerosis.

Based on the JavaScript reference implementation (forked from adobrasinovic/edss).

Installation

Usage

Direct calculation with individual scores

Parameter names match the JS reference: calculateEDSS(visualFunctionsScore, brainstemFunctionsScore, pyramidalFunctionsScore, cerebellarFunctionsScore, sensoryFunctionsScore, bowelAndBladderFunctionsScore, cerebralFunctionsScore, ambulationScore)

From an associative array

By default, calculateFromArray() expects English field names:

With REDCap Portuguese field names

If your data uses the Portuguese field names from REDCap/REDONE.br, pass the built-in FIELDS_REDCAP_PT mapping:

Custom field mapping

You can define your own field name mapping for any data source:

Score conversions

The Visual and Bowel & Bladder Functional Systems use a wider raw scale that is compressed for EDSS calculation:

Functional Systems

# Functional System Raw Scale Converted Scale JS Parameter Name
1 Visual (Optic) 0-6 0-4 visualFunctionsScore
2 Brainstem 0-5 — brainstemFunctionsScore
3 Pyramidal 0-6 — pyramidalFunctionsScore
4 Cerebellar 0-5 — cerebellarFunctionsScore
5 Sensory 0-6 — sensoryFunctionsScore
6 Bowel & Bladder 0-6 0-5 bowelAndBladderFunctionsScore
7 Cerebral (Mental) 0-5 — cerebralFunctionsScore
8 Ambulation 0-16 — ambulationScore

Note: The Ambulation score (≥3) directly determines the EDSS score (≥5.0). When Ambulation is 0-2, the EDSS is determined by the combination of FS scores.

Algorithm

The EDSS calculation follows a two-phase approach:

Phase 1: Ambulation-driven (EDSS ≥ 5.0)

When the Ambulation score is ≥ 3, it directly maps to an EDSS value:

Ambulation EDSS Description
3 5.0 Walks 200-300m without help
4 5.5 Walks 100-200m without help
5-7 6.0 Assistance needed for walking
8-9 6.5 Bilateral/limited assistance
10 7.0 Wheelchair without help
11 7.5 Wheelchair with help
12 8.0 Restricted to bed/chair
13 8.5 Restricted to bed
14 9.0 Helpless bed patient
15 9.5 Totally helpless
16 10.0 Death due to MS

Phase 2: FS-driven (EDSS 0 – 5.0)

When Ambulation is 0-2, the EDSS is calculated from the combination of the 7 FS scores based on the Kappos scoring table, considering:

Field Name Mappings

The library includes built-in constants for field name mappings:

Constant Description Example field
FIELDS_DEFAULT English names (default) visual_functions_score
FIELDS_REDCAP_PT Portuguese REDCap names edss_func_visuais

You can also pass your own array<string, string> mapping to calculateFromArray().

Other implementations

Language Repository
JavaScript atiweb/edss
Kotlin atiweb/edss-in-kotlin
Flutter/Dart atiweb/edss-in-flutter

Testing

The test suite includes 70+ test cases covering:

References

License

MIT

All versions of edss-in-php with dependencies

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Package Version
Requires php Version >=8.1
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