ECTRIMS eLearning

Validity and responsiveness of SaGAS 10 for rehabilitation research in multiple sclerosis (MS): an improved score for routine assessments
Author(s): ,
L Barin
Affiliations:
Institut für Epidemiologie, Biostatistik, und Prävention, Universität Zürich, Zürich
,
T Rapillard
Affiliations:
Berner Klinik, Crans Montana, Switzerland
,
V Von Wyl
Affiliations:
Institut für Epidemiologie, Biostatistik, und Prävention, Universität Zürich, Zürich
C Vaney
Affiliations:
Berner Klinik, Crans Montana, Switzerland
ECTRIMS Learn. 09/15/16; 146185; P345
Abstract

Abstract: P345

Type: Poster

Abstract Category: Clinical aspects of MS - Clinical assessment tools

Background: SaGAS 10 (Short and Graphic Ability Score) is a score developed as an alternative to the Multiple Sclerosis Functional Composite (MSFC). Compared with MSFC, SaGAS 10 can be less burdensome (due to the omission of PASAT-3) and requires no rescaling to a standard population. It also complements the EDSS (Expanded Disability Status Scale) for MS patients, which is known to be little responsive over short periods. We aimed to examine construct and predictive validity, as well as responsiveness of SaGAS 10 in MS patients attending a rehabilitation facility.

Method: Sagas is composed of the 25 feet timed walk at fast speed with a flying start (T25FW) and the nine-hole peg test (9-HPT) performed for each hand separately. It was measured at the start and end of a rehabilitation stay using a freely available smartphone app (SaGAS 20/10).

Sagas 10 was compared with Rivermead Mobility Index (RMI), the 2-minute timed walking distance at maximum speed (2MWD), and EDSS, measured at the same time points. Construct validity was assessed by Spearman correlation of SaGAS 10 with RMI, 2MWD, and EDSS. A priori coefficients of >0.7, >0.7, and < -0.6 were hypothesized, respectively.

Responsiveness of Sagas was assessed by anchoring with a ≥3-point change on the RMI scale and by calculating receiver operator characteristic curves (ROCs).

Predictive validity was assessed by correlation of SaGAS scores with an decrease ≥3 in RMI in the following 2 years.

Results: 251 patients with MS were included (median EDSS 6, range 2-9; median age 56, median years since diagnosis 17, median stay duration 20 days).

Before and after score differences were 1.49 units (95% CI 1.49-1.5) for RMI, 17.5 meters (14.5-20.5) for 2MWD, 0.75 units (0.6-0.9) for SaGAS 10.

All measured correlation coefficients for SaGAS 10 exceeded hypothesized values: 0.76 for RMI, 0.84 for 2MWD, and -0.67 for EDSS.

Responsiveness was moderate with an AUC of 0.60 (95% CI 0.48-0.72). Also a Spearman correlation of 0.33 was found between SaGAS 10 and the occurrence of an decrease of ≥3 in RMI in the following 2 years.

Conclusions: These results indicate that SaGAS 10 is a valid measure for effectiveness of rehabilitation. It is more sensitive to changes over the time span of an intervention than EDSS and easier to administer than MSFC. Being exclusively based on timed performance tests, SaGAS 10 is also less subjective than the EDSS. Its usage can therefore be recommended for routine rehabilitation assessment.

Disclosure: nothing to disclose

Abstract: P345

Type: Poster

Abstract Category: Clinical aspects of MS - Clinical assessment tools

Background: SaGAS 10 (Short and Graphic Ability Score) is a score developed as an alternative to the Multiple Sclerosis Functional Composite (MSFC). Compared with MSFC, SaGAS 10 can be less burdensome (due to the omission of PASAT-3) and requires no rescaling to a standard population. It also complements the EDSS (Expanded Disability Status Scale) for MS patients, which is known to be little responsive over short periods. We aimed to examine construct and predictive validity, as well as responsiveness of SaGAS 10 in MS patients attending a rehabilitation facility.

Method: Sagas is composed of the 25 feet timed walk at fast speed with a flying start (T25FW) and the nine-hole peg test (9-HPT) performed for each hand separately. It was measured at the start and end of a rehabilitation stay using a freely available smartphone app (SaGAS 20/10).

Sagas 10 was compared with Rivermead Mobility Index (RMI), the 2-minute timed walking distance at maximum speed (2MWD), and EDSS, measured at the same time points. Construct validity was assessed by Spearman correlation of SaGAS 10 with RMI, 2MWD, and EDSS. A priori coefficients of >0.7, >0.7, and < -0.6 were hypothesized, respectively.

Responsiveness of Sagas was assessed by anchoring with a ≥3-point change on the RMI scale and by calculating receiver operator characteristic curves (ROCs).

Predictive validity was assessed by correlation of SaGAS scores with an decrease ≥3 in RMI in the following 2 years.

Results: 251 patients with MS were included (median EDSS 6, range 2-9; median age 56, median years since diagnosis 17, median stay duration 20 days).

Before and after score differences were 1.49 units (95% CI 1.49-1.5) for RMI, 17.5 meters (14.5-20.5) for 2MWD, 0.75 units (0.6-0.9) for SaGAS 10.

All measured correlation coefficients for SaGAS 10 exceeded hypothesized values: 0.76 for RMI, 0.84 for 2MWD, and -0.67 for EDSS.

Responsiveness was moderate with an AUC of 0.60 (95% CI 0.48-0.72). Also a Spearman correlation of 0.33 was found between SaGAS 10 and the occurrence of an decrease of ≥3 in RMI in the following 2 years.

Conclusions: These results indicate that SaGAS 10 is a valid measure for effectiveness of rehabilitation. It is more sensitive to changes over the time span of an intervention than EDSS and easier to administer than MSFC. Being exclusively based on timed performance tests, SaGAS 10 is also less subjective than the EDSS. Its usage can therefore be recommended for routine rehabilitation assessment.

Disclosure: nothing to disclose

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