TY - JOUR
T1 - Redefining the Multiple Sclerosis Severity Score (MSSS)
T2 - The effect of sex and onset phenotype
AU - Zhou, Yuan
AU - Claflin, Suzi B.
AU - Stankovich, Jim
AU - van der Mei, Ingrid
AU - Simpson, Steve
AU - Roxburgh, Richard H.
AU - Kalincik, Tomas
AU - Blizzard, Leigh
AU - Lugaresi, Alessandra
AU - Alroughani, Raed
AU - Sajedi, Seyed Aidin
AU - Butzkueven, Helmut
AU - Pucci, Eugenio
AU - Spitaleri, Daniele L.A.
AU - Granella, Franco
AU - Cristiano, Edgardo
AU - Yamout, Bassem
AU - Hughes, Stella
AU - Gouider, Riadh
AU - Sánchez Menoyo, José Luis
AU - Olascoaga, Javier
AU - McGuigan, Chris
AU - Shaw, Cameron
AU - Kermode, Allan G.
AU - Kasa, Krisztian
AU - Al-Harbi, Talal
AU - Altintas, Ayse
AU - Laureys, Guy
AU - Fragoso, Yara
AU - Hardy, Todd A.
AU - Csepany, Tunde
AU - Sirbu, Carmen Adella
AU - Decoo, Danny
AU - Sas, Attila
AU - Alvarez-Cermeño, Jose C.
AU - Kotkata, Karim
AU - Millán-Pascual, Jorge
AU - Taylor, Bruce V.
PY - 2020/11
Y1 - 2020/11
N2 - Background: The Multiple Sclerosis Severity Score (MSSS) is a widely used measure of the disability progression rate. However, the global MSSS may not be the best basis for comparison between all patient groups. Objective: We evaluated sex-specific and onset phenotype–specific MSSS matrices to determine if they were more effective than the global MSSS as a basis for comparison within these subsets. Methods: Using a large international dataset of multiple sclerosis (MS) patient records and the original MSSS algorithm, we constructed global, sex-specific and onset phenotype–specific MSSS matrices. We compared matrices using permutation analysis. Results: Our final dataset included 30,203 MS cases, with 28.9% males and 6.5% progressive-onset cases. Our global MSSS matrix did not differ from previously published data (p > 0.05). The progressive-onset-specific matrix differed significantly from the relapsing-onset-specific matrix (p < 0.001), with lower MSSS attributed to cases with the same Expanded Disability Status Score (EDSS) and disease duration. When evaluated with a simulation, using an onset-specific MSSS improved statistical power in mixed cohorts. There were no significant differences by sex. Conclusion: The differences in the disability accrual rate between progressive- and relapsing-onset MS have a significant effect on MSSS. An onset-specific MSSS should be used when comparing the rate of disability progression among progressive-onset cases and for mixed cohorts.
AB - Background: The Multiple Sclerosis Severity Score (MSSS) is a widely used measure of the disability progression rate. However, the global MSSS may not be the best basis for comparison between all patient groups. Objective: We evaluated sex-specific and onset phenotype–specific MSSS matrices to determine if they were more effective than the global MSSS as a basis for comparison within these subsets. Methods: Using a large international dataset of multiple sclerosis (MS) patient records and the original MSSS algorithm, we constructed global, sex-specific and onset phenotype–specific MSSS matrices. We compared matrices using permutation analysis. Results: Our final dataset included 30,203 MS cases, with 28.9% males and 6.5% progressive-onset cases. Our global MSSS matrix did not differ from previously published data (p > 0.05). The progressive-onset-specific matrix differed significantly from the relapsing-onset-specific matrix (p < 0.001), with lower MSSS attributed to cases with the same Expanded Disability Status Score (EDSS) and disease duration. When evaluated with a simulation, using an onset-specific MSSS improved statistical power in mixed cohorts. There were no significant differences by sex. Conclusion: The differences in the disability accrual rate between progressive- and relapsing-onset MS have a significant effect on MSSS. An onset-specific MSSS should be used when comparing the rate of disability progression among progressive-onset cases and for mixed cohorts.
KW - disability progression
KW - Multiple sclerosis
KW - Multiple Sclerosis Severity Score
KW - onset phenotype
UR - http://www.scopus.com/inward/record.url?scp=85074863332&partnerID=8YFLogxK
U2 - 10.1177/1352458519881994
DO - 10.1177/1352458519881994
M3 - Article
C2 - 31668127
AN - SCOPUS:85074863332
VL - 26
SP - 1765
EP - 1774
JO - Multiple Sclerosis Journal
JF - Multiple Sclerosis Journal
SN - 1352-4585
IS - 13
ER -