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Disease progression in multiple sclerosis: combining physicians' and patients' perspectives?
J J Kragt1, J M Nielsen, F A H van der Linden
1Department of Neurology, VU University Medical Center, The Netherlands. JJ.Kragt@vumc.nl
Multiple Sclerosis (Houndmills, Basingstoke, England)
|October 28, 2010
Summary
Combining multiple clinical outcome measures significantly enhances the detection of disease progression in multiple sclerosis (MS). This approach, especially when integrating physician and patient perspectives, offers greater sensitivity than single-scale assessments.
Area of Science:
- Neurology
- Clinical Research
- Biostatistics
Background:
- Multiple Sclerosis (MS) disease progression assessment relies on various outcome measures.
- The interrelation and combined use of these scales for MS progression are not extensively studied.
- Combining outcome measures in MS is a recent concept.
Purpose of the Study:
- To explore the combination of different clinical outcome measures for evaluating MS disease progression.
- To assess the impact of combining diverse assessment scales.
Main Methods:
- Studied 553 patients using Expanded Disability Status Scale (EDSS), Nine-Hole Peg Test (9HPT), Timed 25-Foot Walk (T25FW), and MSIS-29.
- Analyzed 'exclusive worsening' and 'opposing changes' across measures.
- Investigated the effect of combined assessments on detecting progression.
Main Results:
- Only 140 patients progressed based on EDSS alone.
- 275 patients showed worsening on any clinical outcome measure, nearly double the EDSS-only count.
- 76% of worsened patients exhibited opposing changes, particularly when combining physician-based and patient-derived measures.
Conclusions:
- Combining multiple outcome measures increases sensitivity for detecting MS disease progression.
- Integrating measures from different perspectives (e.g., physician vs. patient) provides added value.
- Further research is required to determine optimal combination strategies for clinical studies.
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