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Updated: Dec 9, 2025
A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data
Published on: December 9, 2015
SMILE: a predictive model for Scoring the severity of relapses in MultIple scLErosis
F Lejeune1,2, A Chatton3, D-A Laplaud1,2
1Neurology Department and CIC 0004, Nantes University Hospital, Nantes, France.
Background:
In relapsing-remitting multiple sclerosis (RRMS), relapse severity and residual disability are difficult to predict. Nevertheless, this information is crucial both for guiding relapse treatment strategies and for informing patients.
Objective:
We, therefore, developed and validated a clinical-based model for predicting the risk of residual disability at 6 months post-relapse in MS.
Methods:
We used the data of 186 patients with RRMS collected during the COPOUSEP multicentre trial. The outcome was an increase of ≥ 1 EDSS point 6 months post-relapse treatment. We used logistic regression with LASSO penalization to construct the model, and bootstrap cross-validation to internally validate it. The model was externally validated with an independent retrospective French single-centre cohort of 175 patients.
Results:
The predictive factors contained in the model were age > 40 years, shorter disease duration, EDSS increase ≥ 1.5 points at time of relapse, EDSS = 0 before relapse, proprioceptive ataxia, and absence of subjective sensory disorders. Discriminative accuracy was acceptable in both the internal (AUC 0.82, 95% CI [0.73, 0.91]) and external (AUC 0.71, 95% CI [0.62, 0.80]) validations.
Conclusion:
The predictive model we developed should prove useful for adapting therapeutic strategy of relapse and follow-up to individual patients.
