Secondary Progressive Multiple Sclerosis

Neurology Neuroimmunology & Neuroinflammation, Год журнала: 2022, Номер 10(1)

Опубликована: Ноя. 22, 2022

Many challenges exist in the precise diagnosis and clinical management of secondary progressive multiple sclerosis (SPMS) because lack definitive clinical, imaging, immunologic, or pathologic criteria that demarcate transition from relapsing-remitting MS to SPMS. This review provides an overview diagnostic criteria/definition heterogeneity associated with different SPMS patient populations; it also emphasizes importance available prospective/retrospective tools identify patients earlier disease course so approved disease-modifying therapies nonpharmacological strategies will translate into better outcomes. Delivery such interventions necessitates evolving patient-clinician dialog within context a multidisciplinary team.

Язык: Английский

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Should We Use Clinical Tools to Identify Disease Progression?

Frontiers in Neurology, Год журнала: 2021, Номер 11

Опубликована: Янв. 21, 2021

The presence of disability progression in multiple sclerosis (MS) is an important hallmark for MS patients the course their disease. transition from relapsing remitting (RRMS) to secondary progressive forms disease (SPMS) represents a significant change quality life and perception It could also be therapeutic key opportunities, where approaches different those initial phases can adopted. characterization structural biomarkers (e.g., magnetic resonance imaging or neurofilament light chain) has been proposed differentiate between both phenotypes. However, there no definite threshold them. Whether risk clinical predicted by markers at early still focus research. several theories pathological evidence suggest that phenotypes are part continuum with common pathophysiological mechanisms. In this case, evaluation would play preponderant role above destruction identification SPMS. For purpose, use tools beyond Expanded Disability Status Scale (EDSS) should considered. Besides established functional tests such as Multiple Sclerosis Functional Composite (MSFC), patient's neurological history digital resources may help neurologists decision-taking. article, we discuss arguments detection activity.

Язык: Английский

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Multiple Sclerosis Progression Discussion Tool Usability and Usefulness in Clinical Practice: Cross-sectional, Web-Based Survey

Journal of Medical Internet Research, Год журнала: 2021, Номер 23(10), С. e29558 - e29558

Опубликована: Июль 27, 2021

A digital tool, Multiple Sclerosis Progression Discussion Tool (MSProDiscuss), was developed to facilitate discussions between health care professionals (HCPs) and patients in evaluating early, subtle signs of multiple sclerosis (MS) disease progression.The aim this study is report the findings on usability usefulness MSProDiscuss a real-world clinical setting.In cross-sectional, web-based survey, HCPs across 34 countries completed an initial individual questionnaire (comprising 7 questions comprehensibility, usability, after using during each patient consultation) final 13 usefulness, integration adoption into practice capture HCPs' overall experience tool). The responses were provided 5-point Likert scale. All analyses descriptive, no statistical comparisons made.In total, 301 tested tool 6974 people with MS, whom 77% (5370/6974) had relapsing-remitting including those suspected be transitioning secondary progressive MS. time taken complete reported range 1 4 minutes 97.3% (6786/6974; initial) 98.2% (269/274; final) cases. In 93.54% (6524/6974; 97.1% (266/274; cases, agreed (4 or 5 scale) that able comprehend tool. willing use again same patient, 90.47% (6310/6974; useful discussing MS symptoms their impact daily activities (6121/6974, 87.76% 252/274, 92% cognitive function (5482/6974, 78.61% 271/274, 79.2% final), as well progression general (6102/6974, 87.49% 246/274, 89.8% final). While completing questionnaire, 94.9% (260/274) similar asked regular consultation, helped better understand (249/274, 90.9%) (220/274, 80.3%). Overall, (252/274) they would recommend colleague, 85.8% (235/274) integrate it practice.MSProDiscuss usable physician-patient discussion practice. Most easy

Язык: Английский

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MSProDiscuss™ Clinical Decision Support Tool for Identifying Multiple Sclerosis Progression

Journal of Clinical Medicine, Год журнала: 2022, Номер 11(15), С. 4401 - 4401

Опубликована: Июль 28, 2022

This article describes the rationale for development of MSProDiscuss™ clinical decision support (CDS) tool, its development, and insights into how it can help neurologists improve care patients with multiple sclerosis (MS). MS is a progressive disease characterized by heterogeneous symptoms variable course. There growing consensus that exists on continuum, overlap between relapsing-remitting secondary phenotypes. Evidence demonstrates neuroaxonal loss occurs from outset, progression occur independent relapse activity, continuous underlying pathological processes may not be reflected inflammatory activity indicative patient's immune response. Early intervention benefit patients, there need tool assists physicians in rapidly identifying subtle signs progression. MSProDiscuss, developed facilitates structured approach to patient consultations. It analyzes multidimensional data via an algorithm estimate likelihood (the MSProDiscuss score), contribution various symptoms, impact daily living, enabling more personalized treatment management. Data CDS tools such as offer new course facilitate informed decision-making holistic care.

Язык: Английский

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Der Multiple Sclerosis Health Resource Utilization Survey

Fortschritte der Neurologie · Psychiatrie, Год журнала: 2021, Номер 90(01/02), С. 42 - 48

Опубликована: Май 18, 2021

Zusammenfassung Hintergrund In gesundheitsökonomischen Studien sind valide und verlässliche Kostendaten essentiell, um belastbare Schlussfolgerungen zu ziehen eine höchstmögliche Versorgungsqualität der Patienten sicherzustellen. Im Falle Multiplen Sklerose (MS) basieren solche häufig auf Primärdaten, deren zugrundeliegende Erhebungsinstrumente nicht publiziert sind. Zudem erschweren heterogene Methoden die Vergleichbarkeit Interpretation solcher Studienergebnisse. Zur Vereinheitlichung gesundheitsökonomischer in MS wurde Multiple Sclerosis Health Resource Utilization Survey (MS-HRS) entwickelt, validiert frei zugänglich publiziert. Fragestellung Fokus dieser Übersichtsarbeit bildet MS-HRS. Wir berichten methodische Grundlagen zur Krankheitskostenerfassung sowie MS-HRS basierte Ergebnisse den Kosten Krankheitsdynamik bei Personen mit MS. Material/Methodik Dieser Artikel beruht einer selektiven Literaturrecherche zum Aspekten Krankheitskostenerfassung. Der erfasst patientenberichtet gesellschaftliche Inanspruchnahme von direkten medizinischen, nicht-medizinischen indirekten Ressourcen. Indirekte werden weiterhin zwischen Absentismus, sowohl kurzzeitig (Krankheitstage) als auch langfristig (Erwerbs-/Berufsunfähigkeit), Präsentismus unterschieden. Ressourcenverbrauch wird gesellschaftlichen Opportunitätskosten approximiert. Erste Analysen zeigen, dass neben dem stationären Behinderungsgrad klinischen Verlauf Form Schüben Progression enorme sozioökonomische Auswirkungen hat. Diskussion Valide Krankheitskostendaten bringen Transparenz ökonomischen Erkrankungen. Ergänzung Daten kann Kosteneffektivität festgestellt somit Anhaltspunkte für effizientere Patientenversorgung aufgedeckt werden. steht Kostenerfassung ein zugängliches Instrument Verfügung.

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Multiple Sclerosis Progression Discussion Tool Usability and Usefulness in Clinical Practice: Cross-sectional, Web-Based Survey (Preprint)

Опубликована: Апрель 13, 2021

A digital tool, Multiple Sclerosis Progression Discussion Tool (MSProDiscuss), was developed to facilitate discussions between health care professionals (HCPs) and patients in evaluating early, subtle signs of multiple sclerosis (MS) disease progression. The aim this study is report the findings on usability usefulness MSProDiscuss a real-world clinical setting. In cross-sectional, web-based survey, HCPs across 34 countries completed an <i>initial</i> individual questionnaire (comprising 7 questions comprehensibility, usability, after using during each patient consultation) <i>final</i> 13 usefulness, integration adoption into practice capture HCPs’ overall experience tool). responses were provided 5-point Likert scale. All analyses descriptive, no statistical comparisons made. total, 301 tested tool 6974 people with MS, whom 77% (5370/6974) had relapsing-remitting including those suspected be transitioning secondary progressive MS. time taken complete reported range 1 4 minutes 97.3% (6786/6974; <i>initial</i>) 98.2% (269/274; <i>final</i>) cases. 93.54% (6524/6974; 97.1% (266/274; cases, agreed (4 or 5 scale) that able comprehend tool. willing use again same patient, 90.47% (6310/6974; useful discussing MS symptoms their impact daily activities (6121/6974, 87.76% 252/274, 92% cognitive function (5482/6974, 78.61% 271/274, 79.2% <i>final</i>), as well progression general (6102/6974, 87.49% 246/274, 89.8% <i>final</i>). While completing final questionnaire, 94.9% (260/274) similar asked regular consultation, helped better understand (249/274, 90.9%) (220/274, 80.3%). Overall, (252/274) they would recommend colleague, 85.8% (235/274) integrate it practice. usable physician-patient discussion Most easy

Язык: Английский

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