Contributions
Abstract: EP1404
Type: ePoster
Abstract Category: Clinical aspects of MS - 8 Clinical assessment tools
Introduction: Relapse rate and changes in MRI and the Expanded Disability Status Scale (EDSS) are universally used as indicators of therapeutic efficacy in disease modifying treatments in multiple sclerosis (MS). Though, the EDSS has limitations, namely, in the assessment of cognitive dysfunction.
Objective: To investigate the accuracy of clinical measures in the detection of disease activity.
Methods: Patients with MS were evaluated using clinical and MRI measures in two different moments. Disease activity was defined as ≥1 relapses and/or changes in MRI (≥2 Gd-enhancing or new T2 lesions). It was considered a change (“clinically meaningful worsening”) if EDSS≥1, Timed 25-foot walk (T25FW) ≥20%, 9-hole peg test (9HPT) ≥20%, and symbol digit modality test (SDMT) ≥10%. Classification accuracy statistics and Fisher's exact were applied.
Results: Of the 132 patients included (67% females, age=42±11, education=14±6, disease duration=12±7 years; first evaluation EDSS=2.6±3.4, 85% were under disease modifying treatment and time between evaluations=12±5 months), 43 (33%) met the criteria for disease activity. Changes in EDSS and SDMT correctly classified (sensitivity) respectively 23/43 (54%) and 26/43 (61%) patients with disease activity. However, there was a modest association between changes in EDSS and SDMT (p=0.029; 34/132 patients had changes in one measure but not on the other). When combined, the sensitivity and specificity of EDSS and SDMT reached respectively 93% and 97%. The sensitivity of changes in T25FW (16%) and 9HPT (5%) was low.
Conclusion: Changes in EDSS and SDMT have high accuracy in the detection of disease activity. Though, these clinical measures may be sensitive to different aspects of disease activity.
Disclosure: Nothing to disclose
Abstract: EP1404
Type: ePoster
Abstract Category: Clinical aspects of MS - 8 Clinical assessment tools
Introduction: Relapse rate and changes in MRI and the Expanded Disability Status Scale (EDSS) are universally used as indicators of therapeutic efficacy in disease modifying treatments in multiple sclerosis (MS). Though, the EDSS has limitations, namely, in the assessment of cognitive dysfunction.
Objective: To investigate the accuracy of clinical measures in the detection of disease activity.
Methods: Patients with MS were evaluated using clinical and MRI measures in two different moments. Disease activity was defined as ≥1 relapses and/or changes in MRI (≥2 Gd-enhancing or new T2 lesions). It was considered a change (“clinically meaningful worsening”) if EDSS≥1, Timed 25-foot walk (T25FW) ≥20%, 9-hole peg test (9HPT) ≥20%, and symbol digit modality test (SDMT) ≥10%. Classification accuracy statistics and Fisher's exact were applied.
Results: Of the 132 patients included (67% females, age=42±11, education=14±6, disease duration=12±7 years; first evaluation EDSS=2.6±3.4, 85% were under disease modifying treatment and time between evaluations=12±5 months), 43 (33%) met the criteria for disease activity. Changes in EDSS and SDMT correctly classified (sensitivity) respectively 23/43 (54%) and 26/43 (61%) patients with disease activity. However, there was a modest association between changes in EDSS and SDMT (p=0.029; 34/132 patients had changes in one measure but not on the other). When combined, the sensitivity and specificity of EDSS and SDMT reached respectively 93% and 97%. The sensitivity of changes in T25FW (16%) and 9HPT (5%) was low.
Conclusion: Changes in EDSS and SDMT have high accuracy in the detection of disease activity. Though, these clinical measures may be sensitive to different aspects of disease activity.
Disclosure: Nothing to disclose