A Physician-Completed Digital Tool for Evaluating Disease Progression (Multiple Sclerosis Progression Discussion...

Area of Science:

• Neurology
• Digital Health Tools
• Multiple Sclerosis (MS) Research

Background:

• Distinguishing between relapsing-remitting multiple sclerosis (RRMS) and secondary progressive multiple sclerosis (SPMS) is clinically challenging, often leading to delayed diagnosis of disease progression.
• A novel digital tool, MSProDiscuss, was developed to assist healthcare professionals in evaluating subtle indicators of MS progression that signify the transition from RRMS to SPMS.

Purpose of the Study:

• To establish cut-off values for scoring algorithms, with and without the Expanded Disability Status Scale (EDSS), to accurately differentiate between RRMS and SPMS.
• To assess the sensitivity, specificity, and psychometric properties of the MSProDiscuss tool in classifying MS disease phenotypes.

Main Methods:

• Twenty neurologists utilized the MSProDiscuss tool for 198 patients diagnosed with RRMS, SPMS, or suspected transition to SPMS.
• Patient data included age, EDSS scores, and current disease status (activity, symptoms, daily life impacts).
• Receiver operating characteristic (ROC) curves were employed to determine optimal cut-off values for classification.

Main Results:

• The MSProDiscuss tool demonstrated significant differences in mean scores across RRMS, transitioning, and SPMS patient groups (P<.001).
• Area Under the Curve (AUC) values for differentiating RRMS and SPMS were high, both with (0.91) and without (0.88 for RRMS, 0.86 for SPMS) EDSS inclusion.
• Optimal cut-off values yielded high sensitivity and specificity (e.g., RRMS: ≤51.6, sensitivity=0.83, specificity=0.82 with EDSS; SPMS: ≥58.9, sensitivity=0.82, specificity=0.84 with EDSS).
• The tool exhibited excellent interrater reliability (intraclass correlation coefficient=.95).

Conclusions:

• The MSProDiscuss tool accurately distinguishes between RRMS and SPMS patients, offering high sensitivity and specificity.
• This digital instrument is valuable for clinical practice in identifying early signs of MS progression and the RRMS to SPMS transition.
• MSProDiscuss facilitates objective assessment of disease progression and enhances informed physician-patient communication regarding multiple sclerosis management.