6533b7d1fe1ef96bd125c4cf

RESEARCH PRODUCT

Towards a validated definition of the clinical transition to secondary progressive multiple sclerosis: A study from the Italian MS Register.

Pietro IaffaldanoGiuseppe LucisanoTommaso GuerraFrancesco PattiMarco OnofrjVincenzo Brescia MorraMauro ZaffaroniCarlo PozzilliEleonora CoccoPatrizia SolaGiuseppe SalemiMatilde IngleseRoberto BergamaschiClaudio GasperiniAntonella ConteMarco SalvettiGiacomo LusGiorgia Teresa ManiscalcoRocco TotaroMarika VianelloFranco GranellaElisabetta FerraroUmberto AgugliaMaurizia GattoFrancesca SangalliClara Grazia ChisariGiovanna De LucaAntonio CarotenutoDamiano BaronciniDelia ColomboMihaela NicaDamiano PaolicelliGiancarlo ComiMassimo FilippiMaria Pia AmatoMaria Trojano

subject

Multiple SclerosisMultiple Sclerosis Chronic ProgressiveMultiple sclerosisMultiple Sclerosis Relapsing-RemittingNeurologybig dataArea Under Curvedata-driven algorithmdisease registrysecondary progressiveHumansSettore MED/26 - NeurologiaNeurology (clinical)prognosis

description

Background: Definitions for reliable identification of transition from relapsing-remitting multiple sclerosis (MS) to secondary progressive (SP)MS in clinical cohorts are not available. Objectives: To compare diagnostic performances of two different data-driven SPMS definitions. Methods: Data-driven SPMS definitions based on a version of Lorscheider’s algorithm (DDA) and on the EXPAND trial inclusion criteria were compared, using the neurologist’s definition (ND) as gold standard, in terms of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), Akaike information criterion (AIC) and area under the curve (AUC). Results: A cohort of 10,240 MS patients with ⩾5 years of follow-up was extracted from the Italian MS Registry; 880 (8.5%) patients were classified as SPMS according to the neurologist definition, 1806 (17.6%) applying the DDA and 1134 (11.0%) with the EXPAND definition. The DDA showed greater discrimination power (AUC: 0.8 vs 0.6) and a higher sensitivity (77.1% vs 38.0%) than the EXPAND definition, with similar specificity (88.0% vs 91.5%). PPV and NPV were higher using the DDA than considering EXPAND definition (37.5% vs 29.5%; 97.6% vs 94.0%). Conclusion: Data-driven definitions demonstrated greater ability to capture SP transition than neurologist’s definition and the global accuracy of DDA seems to be higher than the EXPAND definition.

yearjournalcountryeditionlanguage
2022-08-17Multiple sclerosis (Houndmills, Basingstoke, England)
10.1177/13524585221114007https://pubmed.ncbi.nlm.nih.gov/35971322