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The Multiple Sclerosis Performance Test MSPT: An iPad-Based Disability Assessment Tool
Published on: June 30, 2014
From checkboxes to emojis: a novel approach to patient-reported outcomes in multiple sclerosis
Nur Neyal1,2, Katelynn J Krey3, Holly A Morrison4
1Department of Radiology, Mayo Clinic, 200 1 st St SW, Rochester, MN, 55905, USA.
Background:
Patient-reported outcome measures (PROMs) improve multiple sclerosis (MS) management by reflecting patients' perspectives of their disease. Mayo Clinic Electronic Emoji Based Neurological Impairment Status (MEBNIS) is a short PROM consisting of four equally-weighted domains (MemoryMEBNIS, MoodMEBNIS, Fatigue-SleepinessMEBNIS, and AmbulationMEBNIS) and CompositeMEBNIS, which are based on emojis.
Objective:
To investigate the correlations of MEBNIS with patient-reported, examination-based, performance-based, and radiological metrics of disease severity in persons with MS (pwMS).
Methods:
PwMS (n = 195) prospectively completed MEBNIS, Expanded Disability Status Scale (EDSS), MS Functional Composite (MSFC) and its subtests [25-Foot Walk Test (25FWT), 9-Hole Peg Test (9HPT), Paced Auditory Serial Addition Test (PASAT)], Beck Depression Inventory (BDI), Fatigue Questionnaire (FQ), and Epworth Sleepiness Scale (ESS) between May 2021 and May 2024. Participants also underwent brain MRIs. Correlations were summarized using Spearman's rank correlation coefficients.
Results:
MemoryMEBNIS correlated (p≤0.001) with PASAT (rho = -0.25), ESS (rho = 0.24), FQ (rho = 0.36), and BDI (rho = 0.36). MoodMEBNIS correlated (p<0.001) with FQ (rho = 0.40) and BDI (rho = 0.46). Fatigue-SleepinessMEBNIS correlated (p<0.001) with ESS (rho = 0.49), FQ (rho = 0.59), and BDI (rho = 0.44). AmbulationMEBNIS correlated (p<0.001) with EDSS (rho = 0.69), MSFC z-score (rho = -0.59), 25FWT (rho = 0.66), 9HPT (rho = 0.54), PASAT (rho = -0.32), FQ (rho = 0.41), and BDI (rho = 0.37). CompositeMEBNIS correlated (p<0.001) with EDSS (rho = 0.47), MSFC z-score (rho = -0.42), 25FWT (rho = 0.49), 9HPT (rho = 0.36), PASAT (rho = -0.26), ESS (rho = 0.38), FQ (rho = 0.64), and BDI (rho = 0.58). MemoryMEBNIS, AmbulationMEBNIS and CompositeMEBNIS correlated with cortical gray matter (MemoryMEBNIS rho = -0.17; AmbulationMEBNIS rho = -0.30; CompositeMEBNIS rho = -0.20) and thalamus (MemoryMEBNIS rho = -0.17; AmbulationMEBNIS rho = -0.20; CompositeMEBNIS rho = -0.17) volumes (p<0.05).
Conclusions:
As a novel visual PROM, MEBNIS correlates with established patient-reported, examination-based, performance-based, and radiological metrics of MS severity. It offers a fast, intuitive, and accessible multi-domain evaluation of impairment and disease severity in MS, applicable to both clinical practice and clinical trials as a potential digital tool.
Insights
The Mayo Clinic Electronic Emoji Based Neurological Impairment Status (MEBNIS) effectively correlates with established measures of multiple sclerosis (MS) severity. This novel visual tool offers a quick and accessible way to assess MS impairment in clinical practice and trials.
Area of Science:
- Neurology
- Medical Informatics
Background:
- Patient-reported outcome measures (PROMs) are crucial for managing multiple sclerosis (MS) by incorporating patient perspectives.
- The Mayo Clinic Electronic Emoji Based Neurological Impairment Status (MEBNIS) is a novel, emoji-based PROM assessing Memory, Mood, Fatigue-Sleepiness, and Ambulation.
Purpose of the Study:
- To evaluate the correlations between the MEBNIS tool and various established metrics of MS disease severity.
- Investigate associations with patient-reported, examination-based, performance-based, and radiological measures.
Main Methods:
- 195 persons with MS (pwMS) prospectively completed MEBNIS alongside established scales: EDSS, MSFC, BDI, FQ, and ESS.
- Cognitive, functional, and mood assessments were performed, along with brain MRI.
- Correlations were analyzed using Spearman's rank correlation coefficients.
Main Results:
- MEBNIS domains showed significant correlations with multiple established MS severity metrics (p≤0.001).
- AmbulationMEBNIS strongly correlated with EDSS (rho=0.69) and 25FWT (rho=0.66).
- MEBNIS domains also correlated with brain imaging metrics, including cortical gray matter and thalamus volumes.
Conclusions:
- MEBNIS demonstrates significant correlations with established clinical, functional, and radiological MS severity indicators.
- This visual PROM provides a rapid, intuitive, and accessible multi-domain assessment for MS.
- MEBNIS is a promising digital tool for both clinical practice and clinical trials in MS management.
