Contributions
Abstract: P1025
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Background: The Multiple Sclerosis Performance Test (MSPT) comprises a battery of patient-reported outcomes (PROs) and quantitative neuroperformance assessments (NPA) modeled after the multiple sclerosis functional composite, and self-administered at the start of office visits, using an iPad®. In 2017, the MSPT was broadly implemented in clinical practice at the Mellen Center, replacing the traditional MSFC. The timed 25-foot walk (T25FW) was collected in 51% of patients, 9-hole peg test (9HPT) in 43%, and symbol-digit modalities test (SDMT) and low-contrast visual acuity (LCVA) in 0% before the MSPT.
Goals: Improve the availability of quantitative NPA/PROs data available for clinical care and research in a large clinical practice.
Methods: Demographics, Walking Speed Test (WST, equivalent to T25FW), Manual Dexterity Test (MDT, 9HPT), Processing Speed Test (PST, SDMT), Visual Contrast Sensitivity Test (CST, LCVA), Patient Health Questionnaire (PHQ-9), Quality of Life in Neurological Disorders (Neuro-QOL), Patient-Reported Outcomes Measurement Information System (PROMIS-10), and Patient Determined Disease Steps (PDDS) were electronically recorded for established patients with MS at routine office visits between 12/2015 and 11/2017, stored in a secure cloud, and analyzed using descriptive statistics and Spearman correlation coefficient (ρ).
Results: We analyzed 5751 visits by 3281 MS patients with mean age (y) 49.4±12.2, 33.7% progressive MS, median disease (y) duration 13.8 (6.7-22.0), and median PDDS 1.0 (1.0-3.0). Completion rates per month were highest for WST and MDT 80.1-98.1%, PST 72.4-94.7%, CST 30.9-58.8%, PHQ9 and PROMIS-10 84-100%, and Neuro-QOL 64.1-93.1%. The number of completed PROs/NPA in a single encounter was correlated with age (ρ=-0.22) and disability measured by PDDS (ρ=-0.22), PST score (ρ=0.3), 9HPT (ρ=-0.25), and T25FW (ρ=-0.19) (p< 0.0001 for all), but not with depression measured by PHQ9. The mean times (sec) to complete the NPA with instructions/trials were: WST 144.1± 52.7, MDT 271.7 ± 81.7, PST 279.4 ± 51.6, and CST 400.2 ± 102.1. Completion times for the CST and PST significantly decreased from the 1st to 2nd visit (likely due to improved familiarity), but not for the T25FW and 9HPT. Completion times for each NPA with instructions/trials correlated with age, PDSS, T25FW, 9HPT, LCVA, and SDMT.
Conclusions: The MSPT facilitates comprehensive routine collection of NPA and PROs for use in clinical care and clinical research.
Disclosure: Dr. Gabrielle Macaron is supported by Biogen Fellowship Grant # 6873-P-FEL
Dr. Brandon Moss is supported by National Multiple Sclerosis Society Institutional Clinician Training Award ICT 0002.
Hong Li: nothing to disclose.
Malory Weber: nothing to disclose.
Dr. Deborah Miller has served as a consultant for Hoffman-Roche, Ltd
David Schindler received royalties from the Cleveland Clinic for licensing MSPT-related technology, and is an employee and stock holder of Qr8Health.
Dr. Jay Alberts received funding from Department of Defense, NIH, Davis Phinney Foundation, and National Science Foundation
Dr. Stephen Rao has received honoraria, royalties or consulting fees from: Biogen, Genzyme, Novartis, American Psychological Association, International Neuropsychological Society and research funding from the National Institutes of Health, US Department of Defense, National Multiple Sclerosis Society, CHDI Foundation, Biogen, and Novartis.
Dr. Jeffrey Cohen received personal fees for consulting from Adamas, Celgene, Convelo, EMD Serono, Novartis, and PendoPharm; speaking for Mylan; and serving as Co-Editor of Mult Scler J - ETC.
Dr. Robert Bermel has served as a consultant for Biogen, Genzyme, Genentech, and Novartis. He receives research support from Biogen and Genentech.
Abstract: P1025
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Background: The Multiple Sclerosis Performance Test (MSPT) comprises a battery of patient-reported outcomes (PROs) and quantitative neuroperformance assessments (NPA) modeled after the multiple sclerosis functional composite, and self-administered at the start of office visits, using an iPad®. In 2017, the MSPT was broadly implemented in clinical practice at the Mellen Center, replacing the traditional MSFC. The timed 25-foot walk (T25FW) was collected in 51% of patients, 9-hole peg test (9HPT) in 43%, and symbol-digit modalities test (SDMT) and low-contrast visual acuity (LCVA) in 0% before the MSPT.
Goals: Improve the availability of quantitative NPA/PROs data available for clinical care and research in a large clinical practice.
Methods: Demographics, Walking Speed Test (WST, equivalent to T25FW), Manual Dexterity Test (MDT, 9HPT), Processing Speed Test (PST, SDMT), Visual Contrast Sensitivity Test (CST, LCVA), Patient Health Questionnaire (PHQ-9), Quality of Life in Neurological Disorders (Neuro-QOL), Patient-Reported Outcomes Measurement Information System (PROMIS-10), and Patient Determined Disease Steps (PDDS) were electronically recorded for established patients with MS at routine office visits between 12/2015 and 11/2017, stored in a secure cloud, and analyzed using descriptive statistics and Spearman correlation coefficient (ρ).
Results: We analyzed 5751 visits by 3281 MS patients with mean age (y) 49.4±12.2, 33.7% progressive MS, median disease (y) duration 13.8 (6.7-22.0), and median PDDS 1.0 (1.0-3.0). Completion rates per month were highest for WST and MDT 80.1-98.1%, PST 72.4-94.7%, CST 30.9-58.8%, PHQ9 and PROMIS-10 84-100%, and Neuro-QOL 64.1-93.1%. The number of completed PROs/NPA in a single encounter was correlated with age (ρ=-0.22) and disability measured by PDDS (ρ=-0.22), PST score (ρ=0.3), 9HPT (ρ=-0.25), and T25FW (ρ=-0.19) (p< 0.0001 for all), but not with depression measured by PHQ9. The mean times (sec) to complete the NPA with instructions/trials were: WST 144.1± 52.7, MDT 271.7 ± 81.7, PST 279.4 ± 51.6, and CST 400.2 ± 102.1. Completion times for the CST and PST significantly decreased from the 1st to 2nd visit (likely due to improved familiarity), but not for the T25FW and 9HPT. Completion times for each NPA with instructions/trials correlated with age, PDSS, T25FW, 9HPT, LCVA, and SDMT.
Conclusions: The MSPT facilitates comprehensive routine collection of NPA and PROs for use in clinical care and clinical research.
Disclosure: Dr. Gabrielle Macaron is supported by Biogen Fellowship Grant # 6873-P-FEL
Dr. Brandon Moss is supported by National Multiple Sclerosis Society Institutional Clinician Training Award ICT 0002.
Hong Li: nothing to disclose.
Malory Weber: nothing to disclose.
Dr. Deborah Miller has served as a consultant for Hoffman-Roche, Ltd
David Schindler received royalties from the Cleveland Clinic for licensing MSPT-related technology, and is an employee and stock holder of Qr8Health.
Dr. Jay Alberts received funding from Department of Defense, NIH, Davis Phinney Foundation, and National Science Foundation
Dr. Stephen Rao has received honoraria, royalties or consulting fees from: Biogen, Genzyme, Novartis, American Psychological Association, International Neuropsychological Society and research funding from the National Institutes of Health, US Department of Defense, National Multiple Sclerosis Society, CHDI Foundation, Biogen, and Novartis.
Dr. Jeffrey Cohen received personal fees for consulting from Adamas, Celgene, Convelo, EMD Serono, Novartis, and PendoPharm; speaking for Mylan; and serving as Co-Editor of Mult Scler J - ETC.
Dr. Robert Bermel has served as a consultant for Biogen, Genzyme, Genentech, and Novartis. He receives research support from Biogen and Genentech.