0573 The multiple sclerosis severity score: Optimising the use of cross sectional disability to measure disease severity

2005 ◽  
Vol 238 ◽  
pp. S244
Keyword(s):  
Multiple Sclerosis ◽  
Disease Severity ◽  
Severity Score ◽  
Cross Sectional

scholarly journals Relationship between disease severity and folate status of children with sickle cell anaemia in Enugu, South East Nigeria

2021 ◽  
Vol 21 (2) ◽  
pp. 759-764
Author(s):  
Uchenna C Nnajekwu ◽  
Chukwubike O Nnajekwu ◽  
Vivian O Onukwuli ◽  
Ndubuisi A Uwaezuoke ◽  
Osita U Ezenwosu ◽  
...  
Keyword(s):  
Disease Severity ◽  
Sickle Cell ◽  
Severity Score ◽  
Sickle Cell Anaemia ◽  
Life Time ◽  
Folate Deficiency ◽  
Relevant Information ◽  
Folate Supplementation ◽  
Cross Sectional ◽  
Folate Status

Background: Repeated crises in children with sickle cell anaemia (SCA), which is a manifestation of disease severity, results in depletion of their minimal tissue folate stores, with higher likelihood of folate deficiency. The study aimed to determine the relationship between disease severity and the folate status of children with SCA attending University of Nigeria Teaching Hospital (UNTH), Enugu. Methods: This was a hospital based, cross-sectional study conducted between September 2018 and March 2019. One hundred participants were recruited, consisting of 50 children having sickle cell crisis and 50 age and gender matched hae- moglobin AA genotype controls. Relevant information was documented using a pretested questionnaire. Sickle cell severity score was determined using frequency of crisis, admissions and transfusions in the preceding one year, degree of liver and splenic enlargement, life-time cummulative frequency of specific complications of SCA, leucocyte count and haematocrit. Results: Folate deficiency was observed in eight percent of the subjects and none of the controls. The difference was not significant (Fisher’s exact = 4.167, p=0.117). The odds of being folate deficient was 8.5 times more likely during anaemic crisis than in vaso-occlusive crisis, though not significant (95% C.I 0.05 – 89.750, p = 0.075). The mean SCA severity score was 8.06 ± 3.64, signifying a moderate SCA severity in the study population. There was a no relationship between folate status and severity of SCA (Fisher’s exact = 0.054, p = 0.949) Conclusion: Folate status in children with SCA is not affected by their disease severity. Therefore, there may be no need for additional folate supplementation with increasing severity of sickle cell anaemia. Keywords: Sickle cell anaemia; disease severity; folate status; children; Enugu.

scholarly journals Age Related Multiple Sclerosis Severity Score: Disability ranked by age

2017 ◽  
Vol 23 (14) ◽  
pp. 1938-1946 ◽  
Author(s):  
Ali Manouchehrinia ◽  
Helga Westerlind ◽  
Elaine Kingwell ◽  
Feng Zhu ◽  
Robert Carruthers ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Severity Score ◽  
Statistical Power ◽  
Disease Duration ◽  
Population Based ◽  
Cross Sectional ◽  
The United Kingdom ◽  
Age Related ◽  
Versatile Tool ◽  
Study Population

Background: The Multiple Sclerosis Severity Score (MSSS) is obtained by normalising the Expanded Disability Status Scale (EDSS) score for disease duration and has been a valuable tool in cross-sectional studies. Objective: To assess whether use of age rather than the inherently ambiguous disease duration was a feasible approach. Method: We pooled disability data from three population-based cohorts and developed an Age Related Multiple Sclerosis Severity (ARMSS) score by ranking EDSS scores based on the patient’s age at the time of assessment. We established the power to detect a difference between groups afforded by the ARMSS score and assessed its relative consistency over time. Results: The study population included 26058 patients from Sweden ( n = 11846), Canada ( n = 6179) and the United Kingdom ( n = 8033). There was a moderate correlation between EDSS and disease duration ( r = 0.46, 95% confidence interval (CI): 0.45–0.47) and between EDSS and age ( r = 0.44, 95% CI: 0.43–0.45). The ARMSS scores showed comparable power to detect disability differences between groups to the updated and original MSSS. Conclusion: Since age is typically unbiased and readily obtained, and the ARMSS and MSSS were comparable, the ARMSS may provide a more versatile tool and could minimise study biases and loss of statistical power caused by inaccurate or missing onset dates.

Multiple Sclerosis Severity Score: Using disability and disease duration to rate disease severity

Neurology ◽  
2005 ◽  
Vol 64 (7) ◽  
pp. 1144-1151 ◽  
Author(s):  
R. H.S.R. Roxburgh ◽  
S. R. Seaman ◽  
T. Masterman ◽  
A. E. Hensiek ◽  
S. J. Sawcer ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Disease Severity ◽  
Severity Score ◽  
Disease Duration

scholarly journals High prevalence of fatigue in contemporary patients with multiple sclerosis

2021 ◽  
Vol 7 (1) ◽  
pp. 205521732199982
Author(s):  
Line Broch ◽  
Cecilia Smith Simonsen ◽  
Heidi Øyen Flemmen ◽  
Pål Berg-Hansen ◽  
Åshild Skardhamar ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Disease Severity ◽  
Daytime Sleepiness ◽  
Disease Duration ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Disease Modifying Drugs ◽  
High Prevalence ◽  
The Mean ◽  
Anxiety Depression

Objective The prevalence of multiple sclerosis (MS)-related fatigue may have changed due to new diagnostic criteria and new disease modifying drugs. We aimed to assess the prevalence of fatigue in a contemporary MS cohort, and to explore associations between fatigue and clinical and demographic factors. Methods This is a cross-sectional study of the MS population in three Norwegian counties. Fatigue was assessed with the Fatigue Scale for Motor and Cognitive Functions (FSMC). We also assessed self-reported anxiety, depression and daytime sleepiness. Results The response rate was 64% (1599/2512). The mean age of the participants was 52 ± 13 years, median EDSS was 2.5 (IQR 1.5-3.0) and median disease duration from onset was 16 years (IQR 8-25). We found a prevalence of fatigue of 81%. Women had a higher prevalence of fatigue than men (83% vs 78%, p = 0.02). The prevalence increased with age (p < 0.001) and with increasing disease severity (p < 0.001), but in multivariate analyses, only sex and disease severity remained independent determinants of fatigue. Anxiety, depression, and daytime sleepiness were more prevalent in patients with fatigue than in those without fatigue (all p-values < 0.001). Conclusion The prevalence of fatigue is high in contemporary patients with MS. Fatigue is associated with female sex and level of disability, as well as with anxiety, depression and excessive daytime sleepiness.

Analysis of multiple candidate genes in association with phenotypes of multiple sclerosis

2010 ◽  
Vol 16 (6) ◽  
pp. 652-659 ◽  
Author(s):  
Madeleine H Sombekke ◽  
David Arteta ◽  
Mark A van de Wiel ◽  
J Bart A Crusius ◽  
Diego Tejedor ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Single Nucleotide Polymorphisms ◽  
Disease Severity ◽  
Clinical Data ◽  
Severity Score ◽  
Interleukin 2 ◽  
Dna Chip ◽  
Nucleotide Polymorphisms ◽  
Single Nucleotide ◽  
Clinical Variables

Multiple sclerosis is a heterogeneous neurological disease with varying degrees of severity. The common hypothesis is that susceptibility to multiple sclerosis and its phenotype are caused by a combination of environmental and genetic factors. The genetic part exerts its effect through several genes, each having modest effects. We evaluated whether disease severity could be predicted by a model based on clinical data and data from a DNA chip. The DNA chip was designed containing several single nucleotide polymorphisms in 44 genes, previously described to be associated with multiple sclerosis. A total of 605 patients with multiple sclerosis were included in this analysis, using gender, onset type and age at onset as clinical covariates. We correlated 80 single nucleotide polymorphisms to the degree of disease severity using the following three outcome measures: linear Multiple Sclerosis Severity Score, dichotomous Multiple Sclerosis Severity Score (using a cut-off point of 2.5) and time to reach Expanded Disability Status Scale score 6. Sixty-nine single nucleotide polymorphisms were included in the analysis. No individual single nucleotide polymorphism showed a significant association; however, a combination of single nucleotide polymorphisms significantly improved the prediction of disease severity in addition to the clinical variables. In all three models the Interleukin 2 gene was included, confirming a previously reported modest effect on disease severity. The highest power was obtained using the dichotomized Multiple Sclerosis Severity Score as outcome. Several single nucleotide polymorphisms showed their added predictive value over the clinical data in the predictive models. These results support our hypothesis that disease severity is determined by clinical variables and genetic influences (through several genes with small effects) in concert.

scholarly journals New insights into the burden and costs of multiple sclerosis in Europe

2017 ◽  
Vol 23 (8) ◽  
pp. 1123-1136 ◽  
Author(s):  
Gisela Kobelt ◽  
Alan Thompson ◽  
Jenny Berg ◽  
Mia Gannedahl ◽  
Jennifer Eriksson ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Disease Severity ◽  
Purchasing Power Parity ◽  
Burden Of Illness ◽  
Normal Population ◽  
Severe Disease ◽  
Resource Consumption ◽  
Independent Effect ◽  
Power Parity ◽  
Cross Sectional

Background: The current focus in multiple sclerosis (MS) is on early diagnosis and drug intervention, with a view to modifying disease progression. Consequently, healthcare costs have shifted from inpatient care and rehabilitation to outpatient care. Objectives: This European burden of illness study provides data that can be combined with other evidence to assess whether management approaches provide value to society. Methods: A cross-sectional study was conducted in 16 countries. Patients reported on their disease, health-related quality of life (HRQoL) and resource consumption. Descriptive analyses were performed by disease severity. Costs are reported from a societal perspective in 2015€ PPP (adjusted for purchasing power parity). Results: The 16,808 participants had a mean age of 51.5 years, and 52% had relapsing–remitting multiple sclerosis (RRMS). Work capacity declined from 82% to 8%, and utility declined from normal population values to less than zero with advancing disease. Mean costs were 22,800€ PPP in mild, 37,100€ PPP in moderate and 57,500€ PPP in severe disease; healthcare accounted for 68%, 47% and 26%, respectively. Fatigue and cognitive difficulties were reported by 95% and 71% of participants, respectively; both had a significant independent effect on utility. Conclusion: Costs and utility were highly correlated with disease severity, but resource consumption was heavily influenced by healthcare systems organisation and availability of services.

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