Identifying definite patterns of unmet needs in patients with multiple sclerosis using unsupervised machine learning

Area of Science:

• Neurology
• Public Health
• Patient-Reported Outcomes

Background:

• Multiple sclerosis (MS) presents varied patient needs beyond disease progression.
• Understanding unmet needs from the patient perspective is crucial for optimizing daily living and healthcare.
• This study aimed to identify distinct patterns of unmet needs in people with MS (PwMS) and their influencing factors.

Purpose of the Study:

• To identify and characterize distinct patterns of unmet needs among people with multiple sclerosis (PwMS).
• To explore the demographic and clinical determinants associated with these unmet need patterns.
• To inform the development of personalized care strategies for PwMS.

Main Methods:

• A cross-sectional, multicentre study involving 690 PwMS who completed an anonymous online survey.
• Agglomerative hierarchical clustering was used to identify patterns of unmet needs.
• Principal component analysis (PCA) visualized cluster distribution, with pairwise comparisons analyzing demographic and clinical factors.

Main Results:

• Four distinct unmet need patterns were identified: 'information-seekers with few unmet needs', 'high unmet needs', 'socially and assistance-dependent', and 'self-sufficient with few unmet needs'.
• Access to primary care significantly contributed to the overall unmet need burden.
• PCA revealed 'public sphere' (information/care access) and 'private sphere' (assistance/social life) as key components. Older age, lower education, longer disease duration, and higher disability were linked to greater private sphere needs, though not fully explaining the patterns.

Conclusions:

• Four unique patterns of unmet needs exist among PwMS, highlighting the necessity for individualized care approaches.
• Demographic and clinical factors offer partial explanations for these patterns, suggesting other variables are important.
• Further research is needed to fully elucidate the complex factors contributing to unmet needs in the PwMS population.