A multiple sclerosis disease progression measure based on cumulative disability

Abstract

Background: Existing severity measurements in multiple sclerosis (MS) are often cross-sectional, making longitudinal comparisons of disease course between individuals difficult. Objective: The objective of this study is to create a severity metric that can reliably summarize a patient’s disease course. Methods: We developed the nARMSS – normalized ARMSS (age-related MS severity score) over follow-up, using the deviation of individual ARMSS scores from the expected value and integrated over the corresponding time period. The nARMSS scales from −5 to +5; a positive value indicates a more severe disease course for a patient when compared to other patients with similar disease timings. Results: Using Swedish MS registry data, the nARMSS was tested using data at 2 and 4 years of follow-up to predict the most severe quartile during the subsequent period up to 10 years total follow-up. The metric used was area under the curve of the receiver operating characteristic (AUC-ROC). This resulted in measurements of 0.929 and 0.941. In an external Canadian validation cohort, the equivalent AUC-ROCs were 0.901 and 0.908. Conclusion: The nARMSS provides a reliable, generalizable and easily measurable metric which makes longitudinal comparison of disease course between individuals feasible.

Proteomics profiling reveals biomarkers for predicting diagnosis, disease activity and long-term disability outcome in multiple sclerosis

“…To ensure that EDSS scores are comparable across studies, we utilized nARMSS, a score that not only takes into account disease duration and age 33 30 , but also allows for the incorporation of EDSS data from various time points and follow-up periods. This feature enables the comparison of disability progression and outcomes across cohorts with varying levels of data density 31 . Although nARMSS is intended to account for age, we observed an overcorrection for age, and consequently, we found age to be an important factor to include in our nARMSS model.…”

“…The EDSS is the most used measure of disability status, but to adjust for age, the age-related MS score (ARMSS) was created 30 . To further adjust for length of observation time and allow for using data from different lengths of follow-up time, we used the recently described normalized ARMSS (nARMSS; see Methods) 31 . To obtain an nARMSS score, a person had to have had at least two documented EDSS scores over a period of at least three years.…”

Network-based biomarker discovery for multiple sclerosis

“…Based on these assessments, each pwMS with a follow-up period of at least two years, was classified as having evidence of disease activity (EDA) or no evidence of disease activity (NEDA) over two years after baseline sampling (n = 78 samples in the discovery cohort and n = 50 samples in the replication cohort). In addition, the normalised age-related MS score (nARMSS) [164] was calculated for each pwMS with a follow-up period of at least three years (n = 71 samples in the discovery cohort and n = 33 samples in the replication cohort). The nARMSS, derived from age adjusted EDSS scores, summarises the overall disability progression over the entire follow-up period.…”

“…However, many pwMS had shorter follow-up times. While the nARMSS allows the comparison of persons with different follow-up time, the score becomes more accurate with longer follow-up time [164], making longer follow-up durations preferable for such analyses.…”

The Relationship Between Multiple Sclerosis Severity and Fear of Falling Through the Mediating Role of Disability: A Correlational Study

“…Disability is a serious symptom and consequence of MS. Disability means the existence of a functional problem at the physical, personal, and social level in one or several areas of life in interaction with environmental factors and health conditions (18,19). The clinical features of the disease and the emotional and psychological problems of patients with MS lead to disability in different spheres of life, including diminished ability to adapt to the disease, occupational dysfunction, decreased ability to move and walk, fatigue, and aggravated life problems (20).…”