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Estimation of annual probabilities of changing disability levels in Australians with relapsing-remitting multiple sclerosis

Citation

Ahmad, H and van der Mei, I and Taylor, BV and Lucas, RM and Ponsonby, A-L and Lechner-Scott, J and Dear, K and Valery, P and Clarke, PM and Simpson, S and Palmer, AJ and The Ausimmune and AusLong Investigator Groups, Estimation of annual probabilities of changing disability levels in Australians with relapsing-remitting multiple sclerosis, Multiple Sclerosis Journal pp. 1-9. ISSN 1352-4585 (2018) [Refereed Article]

Copyright Statement

Copyright 2018 The Authors

DOI: doi:10.1177/1352458518806103

Abstract

Background: Transition probabilities are the engine within many health economics decision models. However, the probabilities of progression of disability due to multiple sclerosis (MS) have not previously been estimated in Australia.

Objectives: To estimate annual probabilities of changing disability levels in Australians with relapsing-remitting MS (RRMS).

Methods: Combining data from Ausimmune/Ausimmune Longitudinal (2003-2011) and Tasmanian MS Longitudinal (2002-2005) studies (n = 330), annual transition probabilities were obtained between no/mild (Expanded Disability Status Scale (EDSS) levels 0-3.5), moderate (EDSS 4-6.0) and severe (EDSS 6.5-9.5) disability.

Results: From no/mild disability, 6.4% (95% confidence interval (CI): 4.7-8.4) and 0.1% (0.0-0.2) progressed to moderate and severe disability annually, respectively. From moderate disability, 6.9% (1.0-11.4) improved (to no/mild state) and 2.6% (1.1-4.5) worsened. From severe disability, 0.0% improved to moderate and no/mild disability. Male sex, age at onset, longer disease duration, not using immunotherapies greater than 3 months and a history of relapse were related to higher probabilities of worsening.

Conclusion: We have estimated probabilities of changing disability levels in Australians with RRMS. Probabilities differed between various subgroups, but due to small sample sizes, results should be interpreted with caution. Our findings will be helpful in predicting long-term disease outcomes and in health economic evaluations of MS.

Item Details

Item Type:Refereed Article
Keywords:multiple sclerosis, progression, transition probabilities, EDSS, Australia
Research Division:Medical and Health Sciences
Research Group:Neurosciences
Research Field:Central Nervous System
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Nervous System and Disorders
UTAS Author:Ahmad, H (Mr Hasnat Ahmad)
UTAS Author:van der Mei, I (Associate Professor Ingrid van der Mei)
UTAS Author:Taylor, BV (Professor Bruce Taylor)
UTAS Author:Simpson, S (Dr Steve Simpson JR)
UTAS Author:Palmer, AJ (Professor Andrew Palmer)
ID Code:129216
Year Published:2018
Deposited By:Menzies Institute for Medical Research
Deposited On:2018-11-15
Last Modified:2018-12-12
Downloads:0

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