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Published on: December 9, 2015
[MSProDiscuss - Development of a Digital Anamnesis Tool to Identify Disease Progression in Multiple Sclerosis]
Hernan Inojosa1, Katja Akgün1, Katrin Haacke1
1Zentrum für klinische Neurowissenschaften, Klinik für Neurologie, Technische Universität Dresden/ Universitätsklinikum Dresden, Dresden, Deutschland.
Abstract:
During the course of Multiple Sclerosis (MS), most patients with relapsing remitting MS (RRMS) convert to secondary progressive MS (SPMS), an MS-phenotype associated with a steady deterioration of functional ability independent from relapses and worsened prognosis. Due to the heterogeneity of this conversion, SPMS-diagnosis is often challenging and made retrospectively with a delay of several years. In this review, we first discuss advantages and limitations of screening tools for early SPMS-detection such as the SPMS nomogram, the MS prediction score, and the best SPMS definition approach. These screening tools might help to shorten the phase of diagnostic uncertainty. We then focus on the development of MSProDiscuss, a novel web-based tool that helps the treating neurologist to systematically assesses parameters highly relevant for SPMS-conversion during routine anamnesis. These parameters involve disease activity, symptoms, and impacts of the patient's overall symptoms. In a recent validation study, MSProDiscuss demonstrated high sensitivity, specificity, and interrater reliability. MSProDiscuss does not impose an additional time burden on the treating neurologist and its results are easy to interpret by a simple traffic light system. In first usability tests, it was therefore assessed as a helpful tool for the clinical routine. The early detection of clinically significant progression by diagnostic tools such as MSProDiscuss could open a time-window for therapeutic interventions.
Insights
Early detection of secondary progressive multiple sclerosis (SPMS) is crucial. A new tool, MSProDiscuss, aids neurologists in identifying SPMS conversion sooner, potentially improving patient outcomes.
Area of Science:
- Neurology
- Clinical diagnostics
- Neuroimmunology
Background:
- Multiple Sclerosis (MS) progression often involves conversion from relapsing-remitting MS (RRMS) to secondary progressive MS (SPMS).
- SPMS is characterized by steady functional decline, independent of relapses, leading to a poorer prognosis.
- Diagnosing SPMS is challenging due to its heterogeneous nature, often resulting in delayed, retrospective diagnosis.
Purpose of the Study:
- To review existing screening tools for early SPMS detection, including the SPMS nomogram and MS prediction score.
- To introduce MSProDiscuss, a novel web-based tool designed for systematic assessment of SPMS conversion parameters during routine patient anamnesis.
- To evaluate the utility of MSProDiscuss in clinical practice for timely SPMS diagnosis.
Main Methods:
- Review of current literature on SPMS screening tools and their limitations.
- Development and validation of the MSProDiscuss tool, focusing on disease activity, symptoms, and overall impact.
- Assessment of MSProDiscuss's sensitivity, specificity, interrater reliability, usability, and time efficiency in clinical settings.
Main Results:
- Existing screening tools offer potential benefits but have limitations in early SPMS detection.
- MSProDiscuss demonstrated high sensitivity, specificity, and interrater reliability in validation studies.
- The tool is user-friendly, requires no additional time commitment, and provides easily interpretable results via a traffic light system.
Conclusions:
- Early detection of SPMS is critical for timely therapeutic intervention.
- MSProDiscuss offers a practical and efficient solution to aid neurologists in the early diagnosis of SPMS.
- Implementing tools like MSProDiscuss can shorten diagnostic uncertainty and potentially improve patient management and prognosis.
