Multiple Sclerosis Progression Discussion Tool Usability and Usefulness in Clinical Practice: Cross-sectional, Web-Based Survey

Abstract

Background A digital tool, Multiple Sclerosis Progression Discussion Tool (MSProDiscuss), was developed to facilitate discussions between health care professionals (HCPs) and patients in evaluating early, subtle signs of multiple sclerosis (MS) disease progression. Objective The aim of this study is to report the findings on the usability and usefulness of MSProDiscuss in a real-world clinical setting. Methods In this cross-sectional, web-based survey, HCPs across 34 countries completed an initial individual questionnaire (comprising 7 questions on comprehensibility, usability, and usefulness after using MSProDiscuss during each patient consultation) and a final questionnaire (comprising 13 questions on comprehensibility, usability, usefulness, and integration and adoption into clinical practice to capture the HCPs’ overall experience of using the tool). The responses were provided on a 5-point Likert scale. All analyses were descriptive, and no statistical comparisons were made. Results In total, 301 HCPs tested the tool in 6974 people with MS, of whom 77% (5370/6974) had relapsing-remitting MS, including those suspected to be transitioning to secondary progressive MS. The time taken to complete MSProDiscuss was reported to be in the range of 1 to 4 minutes in 97.3% (6786/6974; initial) to 98.2% (269/274; final) of the cases. In 93.54% (6524/6974; initial) to 97.1% (266/274; final) of the cases, the HCPs agreed (4 or 5 on the Likert scale) that patients were able to comprehend the questions in the tool. The HCPs were willing to use the tool again in the same patient, 90.47% (6310/6974; initial) of the cases. The HCPs reported MSProDiscuss to be useful in discussing MS symptoms and their impact on daily activities (6121/6974, 87.76% initial and 252/274, 92% final) and cognitive function (5482/6974, 78.61% initial and 271/274, 79.2% final), as well as in discussing progression in general (6102/6974, 87.49% initial and 246/274, 89.8% final). While completing the final questionnaire, 94.9% (260/274) of the HCPs agreed that the questions were similar to those asked in regular consultation, and the tool helped to better understand the impact of MS symptoms on daily activities (249/274, 90.9%) and cognitive function (220/274, 80.3%). Overall, 92% (252/274) of the HCPs reported that they would recommend MSProDiscuss to a colleague, and 85.8% (235/274) were willing to integrate it into their clinical practice. Conclusions MSProDiscuss is a usable and useful tool to facilitate a physician-patient discussion on MS disease progression in daily clinical practice. Most of the HCPs agreed that the tool is easy to use and were willing to integrate MSProDiscuss into their daily clinical practice.

Multiple sclerosis impairment scale and brain MRI in secondary progressive multiple sclerosis

“…EDSS‐Plus has also been proposed, 35 although it only differs from MSFC by lacking Paced Auditory Serial Addition Test. There is furthermore a need for tools for accurate evaluation of subtle signs of progression in clinical practice, and for that purpose, MS Progression Discussion Tool 36 has been developed.…”

MSProDiscuss™ Clinical Decision Support Tool for Identifying Multiple Sclerosis Progression

“…Early identification of progression in MS is key because disability progression can start early in the disease course, and delays to intervention with DMTs can have a significant impact on long-term prognosis and patient QoL [ 27 , 30 ]. The window of opportunity for interventional treatment to limit irreversible damage is small [ 41 ] and therefore a sensitive tool capable of detecting the early signs of disease progression is essential to maximize long-term brain health [ 34 , 38 , 39 , 40 , 41 ].…”

“…The MSProDiscuss tool has been developed for neurologists to use in structured consultations with their patients, to assist in monitoring the risk of progression by quantitatively assessing multidimensional data, including patient history, and to score the likelihood of progression through the use of an algorithm [ 34 , 38 , 39 , 40 ]. A recent study following regular use of MSProDiscuss in consultations (i.e., every 6 months) demonstrated that the tool allowed HCPs to accurately track longitudinal changes in multiple dimensions in individual patients [ 40 ].…”

“…This narrative review article covers several related topics: the articulation of an unmet need that potentially could be addressed by CDS tools designed to facilitate identification of the risk of progression in MS, description of the development of the MSProDiscuss™ ( (accessed on 19 July 2022)) CDS tool [ 34 , 38 , 39 , 40 ], review of the evidence in support of MSProDiscuss in clinical practice, and provision of insights into how the MSProDiscuss tool helps neurologists improve the care of patients with MS. For context, the MSProDiscuss CDS tool is a web-based application, accessible via a web browser from any device with internet connectivity, and it does not require software installation. It is designed for use by neurologists in structured consultations with patients.…”

“…Use of the tool in subsequent consultations allows neurologists to track progression. The development program demonstrated the MSProDiscuss algorithm has a high level of sensitivity and specificity for differentiation between RRMS and SPMS [ 39 ], and the MSProDiscuss CDS tool has been validated and tested during consultations with approximately 7000 patients with MS (n = 6974) [ 39 , 40 ].…”