Choi et al reported the Milano-Torino Staging (MiToS) system for a patient with amyotrophic lateral sclerosis (ALS). The authors are from King's College London, University of Turin, Mitsubishi Tanube Pharma America, and Policy Analysis, Inc.
Patient selection: amyotrophic lateral sclerosis
Functional domains:
(1) movement (walking and self-care)
(2) swallowing
(3) communicating (speech and handwriting)
(4) breathing (dyspnea or respiratory insufficiency
Parameter
Loss of Independence
Points
movement
in walking or self-care
1
neither
0
swallowing
yes
1
no
0
communication
speech and handwriting
1
speech only
0
handwriting only
0
neither
0
breathing
dyspnea or respiratory insufficiency
1
neither
0
total score =
= SUM(points for all of the functional domains)
Interpretation:
• minimum score: 0
• maximum score: 4
Total Score
Stage
0
0
1
1
2
2
3
3
4
4
death
5
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