Zhou, Y and Claflin, SB and Stankovich, J and van der Mei, I and Simpson Jr, S and Roxburgh, RH and Kalincik, T and Blizzard, L and Lugaresi, A and Alroughani, R and Sajedi, SA and Butzkueven, H and Pucci, E and Spitaleri, D and Granella, F and Cristiano, E and Yamout, B and Hughes, S and Gouider, R and Sanchez Menoyo, JL and Olascoaga, J and McGuigan, C and Shaw, C and Kermode, AG and Kasa, K and Al-Harbi, T and Altintas, A and Laureys, G and Fragoso, Y and Hardy, TA and Csepany, T and Sirbu, CA and Decoo, D and Sas, A and Alvarez-Cermeno, JC and Kotkata, K and Millan-Pascual, J and Taylor, BV, Redefining the Multiple Sclerosis Severity Score (MSSS): the effect of sex and onset phenotype, Multiple Sclerosis Journal, (October) pp. 1-10. ISSN 1352-4585 (2019) [Refereed Article]
Copyright 2019 The Authors
Objective: We evaluated sex-specific and onset phenotype-specific MSSS matrices to determine if they were more effective than the global MSSS as a basis for comparison within these subsets.
Methods: Using a large international dataset of multiple sclerosis (MS) patient records and the original MSSS algorithm, we constructed global, sex-specific and onset phenotype-specific MSSS matrices. We compared matrices using permutation analysis.
Results: Our final dataset included 30,203 MS cases, with 28.9% males and 6.5% progressive-onset cases. Our global MSSS matrix did not differ from previously published data (p > 0.05). The progressive-onset-specific matrix differed significantly from the relapsing-onset-specific matrix (p < 0.001), with lower MSSS attributed to cases with the same Expanded Disability Status Score (EDSS) and disease duration. When evaluated with a simulation, using an onset-specific MSSS improved statistical power in mixed cohorts. There were no significant differences by sex.
Conclusion: The differences in the disability accrual rate between progressive- and relapsing-onset MS have a significant effect on MSSS. An onset-specific MSSS should be used when comparing the rate of disability progression among progressive-onset cases and for mixed cohorts.
|Item Type:||Refereed Article|
|Keywords:||multiple sclerosis, Multiple Sclerosis Severity Score, disability progression, onset phenotype|
|Research Division:||Biomedical and Clinical Sciences|
|Research Field:||Central nervous system|
|Objective Group:||Clinical health|
|Objective Field:||Clinical health not elsewhere classified|
|UTAS Author:||Zhou, Y (Mr Yuan Zhou)|
|UTAS Author:||Claflin, SB (Ms Suzi Claflin)|
|UTAS Author:||van der Mei, I (Professor Ingrid van der Mei)|
|UTAS Author:||Simpson Jr, S (Dr Steve Simpson JR)|
|UTAS Author:||Blizzard, L (Professor Leigh Blizzard)|
|UTAS Author:||Taylor, BV (Professor Bruce Taylor)|
|Deposited By:||Menzies Institute for Medical Research|
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