Abstract: P866
Type: Poster
Abstract Category: Clinical aspects of MS - 4 Natural course
Background: Reports of Quality of Life (QoL) in chronic progressive disease document significantly decreased QoL during early disease stages with improvement at later stages. Though multiple sclerosis (MS) is associated with significantly decreased QoL, relatively little is known about the association between QoL and disease progression.
Objectives: To approximate the relationship between MS disease progression and QoL, we conducted a cross-sectional analysis of the associations between individual QoL domains and MS disability.
Methods: Patients were participating in MS PATHS (Multiple Sclerosis Partners Advancing Technology and Health Solutions), a network of 10 healthcare institutions in the United States and Europe. At their first visit, patients used an iPad-based device, the Multiple Sclerosis Performance Test, to complete a standardized MS history and 12 scales of the Quality of Life in Neurological Disorders (Neuro-QoL) instrument. Patients self-reported disability using the Patient Determined Disease Steps (PDDS), with scores ranging from 0, normal, to 8, bedridden. Neuro-QoL t-scores were regressed on PDDS using linear regression, adjusting for age, education and sex, with fractional polynomials used to capture any non-linear patterns between Neuro-QoL and PDDS. Patients were randomly split into training and test sets, with the best fitting polynomials selected in the training set using Akaike Information Criterion. Unbiased regression coefficient estimates and p-values were obtained by applying the selected polynomial to the test set.
Results: The sample comprised 1353 patients. The mean (SD) age was 48.9 yrs (12), disease duration was 12.2 yrs (9.4), 72% were female and 85% were white. Statistically significant associations were found for each Neuro-QoL scale and PDDS, with increasing MS disability associated with decreasing QoL. The relationship was non-linear for upper extremity and lower extremity function, depression, fatigue, stigma, and sleep, with a rapid decline observed between PDDS 0 and 2, and a much less rapid decline at higher PDDS scores. For anxiety and cognitive function, QoL was worse for patients in the mid-range of PDDS.
Conclusions: Individual Neuro-QoL scales showed statistically significant non-linear relationships with MS disability, with most of the overall decline observed in early disease stages. Studies of MS QoL should account for disability as a potentially significant confounding variable.
Disclosure: Project funded by Biogen, Inc.
Author disclosures:
Deborah Miller has received consulting fees from Hoffmann-Roche and Biogen.
Glenn A. Phillips, Carl de Moor, James R. Williams, Himanshu Pandya, Nate Mockler and Richard Rudick are employees of, and stockholders in, Biogen.
Abstract: P866
Type: Poster
Abstract Category: Clinical aspects of MS - 4 Natural course
Background: Reports of Quality of Life (QoL) in chronic progressive disease document significantly decreased QoL during early disease stages with improvement at later stages. Though multiple sclerosis (MS) is associated with significantly decreased QoL, relatively little is known about the association between QoL and disease progression.
Objectives: To approximate the relationship between MS disease progression and QoL, we conducted a cross-sectional analysis of the associations between individual QoL domains and MS disability.
Methods: Patients were participating in MS PATHS (Multiple Sclerosis Partners Advancing Technology and Health Solutions), a network of 10 healthcare institutions in the United States and Europe. At their first visit, patients used an iPad-based device, the Multiple Sclerosis Performance Test, to complete a standardized MS history and 12 scales of the Quality of Life in Neurological Disorders (Neuro-QoL) instrument. Patients self-reported disability using the Patient Determined Disease Steps (PDDS), with scores ranging from 0, normal, to 8, bedridden. Neuro-QoL t-scores were regressed on PDDS using linear regression, adjusting for age, education and sex, with fractional polynomials used to capture any non-linear patterns between Neuro-QoL and PDDS. Patients were randomly split into training and test sets, with the best fitting polynomials selected in the training set using Akaike Information Criterion. Unbiased regression coefficient estimates and p-values were obtained by applying the selected polynomial to the test set.
Results: The sample comprised 1353 patients. The mean (SD) age was 48.9 yrs (12), disease duration was 12.2 yrs (9.4), 72% were female and 85% were white. Statistically significant associations were found for each Neuro-QoL scale and PDDS, with increasing MS disability associated with decreasing QoL. The relationship was non-linear for upper extremity and lower extremity function, depression, fatigue, stigma, and sleep, with a rapid decline observed between PDDS 0 and 2, and a much less rapid decline at higher PDDS scores. For anxiety and cognitive function, QoL was worse for patients in the mid-range of PDDS.
Conclusions: Individual Neuro-QoL scales showed statistically significant non-linear relationships with MS disability, with most of the overall decline observed in early disease stages. Studies of MS QoL should account for disability as a potentially significant confounding variable.
Disclosure: Project funded by Biogen, Inc.
Author disclosures:
Deborah Miller has received consulting fees from Hoffmann-Roche and Biogen.
Glenn A. Phillips, Carl de Moor, James R. Williams, Himanshu Pandya, Nate Mockler and Richard Rudick are employees of, and stockholders in, Biogen.