Towards a validated definition of the clinical transition to secondary progressive multiple sclerosis: A study from the Italian MS Register
Year: 2022
Type: article
Study design: Observational Study
Abstract: 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.
Source: Multiple Sclerosis Journal
Authors: Pietro Iaffaldano, Giuseppe Lucisano, Tommaso Guerra, Francesco Patti, Marco Onofrj, Vincenzo Brescia Morra, Mauro Zaffaroni, Carlo Pozzilli, Eleonora Cocco, Patrizia Sola, Giuseppe Salemi, Matilde Inglese, Roberto Bergamaschi, Claudio Gasperini, Antonella Conte, Marco Salvetti, Giacomo Lus, Giorgia Teresa Maniscalco, Rocco Totaro, Marika Vianello, Franco Granella, Elisabetta Ferraro, Umberto Aguglia, Maurizia Gatto, Francesca Sangalli, Clara Grazia Chisari, Giovanna De Luca, Antonio Carotenuto, Damiano Baroncini, Delia Colombo, Mihaela Nica, Damiano Paolicelli, Giancarlo Comi, Massimo Filippi, Maria Pia Amato, Maria Trojano
Institutions: University of Bari Aldo Moro, Center for Outcomes Research and Clinical Epidemiology, University of Catania, University of Chieti-Pescara, Ospedale SS. Annunziata, Federico II University Hospital, University of Naples Federico II, Azienda Socio Sanitaria Territoriale della Valle Olona, Azienda Ospedaliera Sant'Andrea, Sapienza University of Rome, University of Cagliari, University of Modena and Reggio Emilia, University of Palermo, Ospedale Policlinico San Martino, University of Genoa, Azienda Ospedaliera San Camillo-Forlanini, Istituto Neurologico Mediterraneo, University of Campania "Luigi Vanvitelli", Ospedale Antonio Cardarelli, Ca' Foncello Hospital, University of Parma, ASL Roma, Ospedale San Filippo Neri, Magna Graecia University, Ospedale Generale Regionale Francesco Miulli, Vita-Salute San Raffaele University, IRCCS Ospedale San Raffaele, IRCCS San Raffaele Roma, Novartis (Italy), University of Florence
Language: English
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4291824973