02304nas a2200313   4500000000100000008004100001653002800042653003000070653003200100653002600132653003000158653002200188653002200210653003700232653001200269653002000281653001200301653001100313653003200324653002800356100001300384700001300397245006900410856005100479300001100530490000700541520142800548022001401976       2007                            d10aSickness Impact Profile10aSeverity of Illness Index10aSensitivity and Specificity10aRetrospective Studies10aPredictive Value of Tests10aPatient Discharge10aPatient Admission10aOutcome Assessment (Health Care)10aNigeria10aMedical Records10aleprosy10aHumans10aDecision Support Techniques10aCross-Sectional Studies1 aEbenso J1 aEbenso B00aMonitoring impairment in leprosy: choosing the appropriate tool.  uhttps://leprosyreview.org/article/78/3/27-0280  a270-800 v783 a<p><strong>OBJECTIVE: </strong>To assess to what extent the Maximum WHO Impairment Grade, the EHF Score and Impairment Summary Form (ISF) reflect changes in impairment, both in number(s) and severity.</p>

<p><strong>DESIGN: </strong>The impairment data at registration and at release from treatment of 444 persons affected by leprosy registered for MDT from 1994-2003 in Federal Capital Territory, Nigeria were analysed using three monitoring tools.</p>

<p><strong>RESULTS: </strong>Of the 444 patients, 92 people had a change (10 deteriorated, 70 improved while 12 had improvement in some parts of their body and deterioration in other parts) in their impairment between Registration and Release from Treatment. Of the 10 people whose impairment status deteriorated, the WHO Grade missed 7 and the EHF score missed 4. The ISF missed none. Of the 70 whose impairment status improved, the WHO grade missed 27; the EHF score missed 20 and the ISF missed 9. The WHO Grade had a sensitivity of 50%, the EHF Score 61% and the ISF 90%. Negative predictive values were 88%, 91% and 98% respectively.</p>

<p><strong>CONCLUSIONS: </strong>The Maximum WHO Impairment Grade use should be limited to an indicator of late case detection. The EHF score is better used at programme level than individual patient level. The ISF is a sensitive tool for monitoring impairments at patient level to aid clinical decision making.</p>
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