Investigation into the relationship between patient reported disease severity (MSIS-29) and a multi-domain objective computerized screening cognitive analysis aattery in people with multiple sclerosis

Objectives To investigate through survey and data linkage, healthcare resource use and costs (except drugs), including who bears the cost, of multiple sclerosis in the United Kingdom by disease severity and type. Methods The United Kingdom Multiple Sclerosis Register deployed a cost of illness survey, completed by people with multiple sclerosis and linked this with data within the United Kingdom Multiple Sclerosis Register and from their hospital records. Resource consumption was categorised as being medical or non-medical and costed by National Health Service and social services estimates for 2018. Results We calculated £509,003 in non-medical costs over a year and £435,488 in medical costs generated over 3 months. People with multiple sclerosis reported self-funding 75% of non-medical costs with non-medical interventions having long-term potential benefits. Costs increased with disability as measured by patient-reported Expanded Disability Status Score and Multiple Sclerosis Impact Scale, with Multiple Sclerosis Impact Scale physical being a more powerful predictor of costs than the patient-reported Expanded Disability Status Score. Two distinct groups were identified: medical and non-medical interventions ( n = 138); and medical interventions only ( n = 399). The medical and non-medical group reported increased disease severity and reduced employment but incurred 80% more medical costs per person than the medical-only group. Conclusions The importance of disability in driving costs is illustrated with balance between medical and non-medical costs consistent with the United Kingdom health environment. People with multiple sclerosis and their families fund a considerable proportion of non-medical costs but non-medical interventions with longer term impact could affect future medical costs.

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Subjective cognitive concern in multiple sclerosis is associated with reduced thalamic and cortical gray matter volumes

Multiple Sclerosis Journal - Experimental Translational and Clinical ◽

10.1177/2055217319827618 ◽

2019 ◽

Vol 5 (1) ◽

pp. 205521731982761 ◽

Cited By ~ 4

Author(s):

Isaiah Kletenik ◽

Enrique Alvarez ◽

Justin M Honce ◽

Brooke Valdez ◽

Timothy L Vollmer ◽

...

Keyword(s):

Multiple Sclerosis ◽

Cognitive Dysfunction ◽

Gray Matter ◽

Brain Volume ◽

Brain Magnetic Resonance Imaging ◽

Regions Of Interest ◽

Patient Reported ◽

Cortical Gray Matter ◽

Gray Matter Volumes ◽

The Relationship

Objective Brain atrophy has been correlated with objective cognitive dysfunction in multiple sclerosis but few studies have explored self-reported subjective cognitive concerns and their relationship to brain volume changes. This study explores the relationship between subjective cognitive concerns in multiple sclerosis and reduced brain volume in regions of interest implicated in cognitive dysfunction. Methods A total of 158 patients with multiple sclerosis completed the Quality of Life in Neurologic Disorders Measures (Neuro-QoL) short forms to assess subjective cognitive concerns and underwent brain magnetic resonance imaging. Regional brain volumes from regions of interest implicated in cognitive dysfunction were measured using NeuroQuant automated volumetric quantitation. Linear regression was used to analyze the relationship between subjective cognitive concerns and brain volume. Results Controlling for age, disease duration, gender, depression and fatigue, increased subjective cognitive concerns were associated with reduced thalamic volume (standardized β = 0.223, t150 =2.406, P = 0.017) and reduced cortical gray matter volume (standardized β = 0.240, t150 = 2.777, P = 0.006). Increased subjective cognitive concerns were not associated with any other regions of interest that were analyzed. Conclusions Subjective cognitive concern in MS is associated with reduced thalamic and cortical gray matter volumes, areas of the brain that have been implicated in objective cognitive impairment. These findings may lend neuroanatomical significance to subjective cognitive concerns and patient-reported outcomes as measured by Neuro-QoL.

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Retrospective cohort study of the relationship between systolic blood pressure variability and multiple sclerosis disability

BMJ Open ◽

10.1136/bmjopen-2019-034355 ◽

2020 ◽

Vol 10 (2) ◽

pp. e034355 ◽

Cited By ~ 1

Author(s):

Myla D Goldman ◽

Seulgi Min ◽

Jennifer M Lobo ◽

Min-Woong Sohn

Keyword(s):

Multiple Sclerosis ◽

Blood Pressure ◽

Cohort Study ◽

Systolic Blood Pressure ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Outcome Measure ◽

Patient Reported Outcome ◽

Patient Reported ◽

The Relationship

ObjectiveTo examine the relationship between visit-to-visit systolic blood pressure (SBP) variability and patient-reported outcome measure of disability in multiple sclerosis (MS) patients.DesignA retrospective cohort study of individuals with MS who completed a patient-determined disease steps (PDDS) scale between 2011 and 2015 at an MS specialty clinic.ParticipantsIndividuals with MS for whom both a completed PDDS scale and ≥3 SBP measures within the prior 12 months of the survey were available.Main outcome measureParticipants were grouped into three classes of disability (no or mild (PDDS 0–1), moderate (2–3), severe (4–7)). SBP variability was calculated as within-subject SD using all SBP measures taken during the past 12 months. SBP variability was analysed by Tertile groups.ResultsNinety-two subjects were included in this analysis. Mean PDDS score was 2.22±1.89. Compared with subjects in Tertile 1 (lowest variability), the odds of being in a higher disability group was 3.5 times higher (OR=3.48; 95% CI: 1.08 to 11.25; p=0.037) in Tertile 2 and 5.2 times higher (OR=5.19; 95% CI: 1.53 to 17.61; p=0.008) in Tertile 3 (highest variability), independent of mean SBP, age, sex, race/ethnicity, body mass index and comorbidities (p for trend=0.008). Mean PDDS scores were 1.52±1.18 in Tertile 1, 2.73±1.02 in Tertile 2 and 2.42±0.89 in Tertile 3 after adjusting for the same covariates.ConclusionsOur results show a significant gradient relationship between SBP variability and MS-related disability. More research is needed to determine the underlying pathophysiological relationship between SBP variability and MS disability progression.

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Investigation into the relationship between digital brain volume and computerized screening assessment of cognitive function in people with multiple sclerosis: objective analytics to quantify disease impact

10.26226/morressier.5b719e455aff74008ae4cdb6 ◽

2018 ◽

Author(s):

Mark Gudesblatt ◽

Jared Srinivasan

Keyword(s):

Multiple Sclerosis ◽

Cognitive Function ◽

Brain Volume ◽

Disease Impact ◽

Screening Assessment ◽

Computerized Screening ◽

The Relationship

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The relationship among depression, subjective cognitive impairment, and neuropsychological performance in multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458506070255 ◽

2007 ◽

Vol 13 (1) ◽

pp. 81-86 ◽

Cited By ~ 56

Author(s):

L Julian ◽

N M Merluzzi ◽

D C Mohr

Keyword(s):

Multiple Sclerosis ◽

Cognitive Impairment ◽

Post Treatment ◽

Neuropsychological Performance ◽

Subjective Cognitive Impairment ◽

Patient Reported ◽

Function Subscale ◽

The Relationship ◽

Subjective Reports

The aim of this study was to examine, within the context of a treatment study, the relative contributions of depression and neuropsychological performance on patient ratings of cognitive functioning in a cohort of 58 moderately-depressed multiple sclerosis (MS) patients. All participants were randomized to one of three 16-week conventional treatments for depression. Assessments were conducted pre and post-treatment using: (1) Cognitive Function subscale of the Multiple Sclerosis Quality of Life-54 (MSQOL-54) to evaluate subjective cognitive impairment (SC), (2) Beck Depression Inventory (BDI), and (3) a neuropsychological index score (NP). Prior to treatment, 8% of the variance in SC was explained by NP, whereas 14% of the variance was explained by BDI, above and beyond NP. At post-treatment, patients were classified as ‘responders’ (BDI<11) and ‘nonresponders’ (BDI≥11). Among those participants classified as ‘responders’, NP accounted for 39% of the variance in SC, and BDI did not significantly predict SC. The results of this study suggest that depression may influence subjective reports of cognitive impairment, but these reports may not be reliably related to objective neuropsychological performance. Furthermore, patients may be more accurate reporters of their cognitive impairment after successful treatment for depression, suggesting that depression decreases the accuracy of patient reported cognitive impairment.

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An algorithm combining VVSYmQ® and VCSS scores may help to predict disease severity in C2 patients

Phlebology The Journal of Venous Disease ◽

10.1177/02683555211023306 ◽

2021 ◽

pp. 026835552110233

Author(s):

Mikel Sadek ◽

Matthew Pergamo ◽

Jose I Almeida ◽

Glenn R Jacobowitz ◽

Lowell S Kabnick

Keyword(s):

Disease Severity ◽

Frequency Distribution ◽

Conservative Therapy ◽

Severe Disease ◽

Scoring Systems ◽

Distribution Analysis ◽

Concordance Analysis ◽

Patient Reported ◽

Pearson's Correlation ◽

The Relationship

Objectives The purpose was to assess whether combining patient reported scores (VVSymQ®) and physician reported scores (VCSS) stratifies disease severity in C2 patients. Methods Consecutive patients were pooled from the VANISH-1 and VANISH-2 cohorts. VCSS and VVSymQ® were calculated for each patient. The relationship between scoring systems was evaluated using Pearson’s correlation and frequency distribution analysis. Results Two-hundred and ten C2 limbs were included. Scoring systems demonstrated: VVSymQ®: mean = 8.72; VCSS: mean = 6.32; correlation (r = 0.22, p = 0.05). Frequency distribution analysis demonstrated 61.4% of patients had low VVSymQ® and low VCSS; 31.3% had elevated VVSymQ® and increased VCSS; 7.3% were inconsistent with C2 disease. Strict concordance analysis revealed 40.5% had VVSymQ® (< 9)/VCSS (0-6), 18.6% had VVSymQ® (≥ 9)/VCSS (7-9), and 2.9% had VVSymQ® (≥9)/VCSS (≥10). Conclusions For combined elevated VVSymQ® and VCSS, moderate/severe disease is corroborated, and intervention may be indicated. For combined lower scores, the disease severity is mild and conservative therapy is more appropriate.

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Quality of Life Model in Multiple Sclerosis: Personality, Mood Disturbance, Catastrophizing and Disease Severity

International Journal of Indian Psychology ◽

10.25215/0301.028 ◽

2015 ◽

Vol 3 (1) ◽

Author(s):

Afsaneh Akhani ◽

Mojtaba Habibi ◽

Zahra Izadikhah ◽

Mani B. Monajemi ◽

Nina Jamshinejad

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Disease Severity ◽

Illness Perception ◽

Type D Personality ◽

Mood Disturbance ◽

Equation Modeling ◽

Type D ◽

The Relationship

Objective: The aim of current study was to investigate the interaction between factors such as personality, catastrophizing, mood disturbance and disease severity, which may affect the quality of life in patients with multiple sclerosis. The result of this study can identify the factors that have an impact on quality of life among these patients and hopefully it may lead to improve the services provided for these patients. Design: One hundred and thirteen participants with multiple sclerosis completed the following questionnaires: Type D Personality (DS-14), Hospital Anxiety and Depression (HADS), Illness Perception (Brief-IPQ) and Quality of Life (SF-36). The Expanded Disability Statue Scale (EDSS) assessed disease severity. Main Outcome Measures: Data was analyzed in structural equation modeling. Results: Type D personality was associated with quality of life and the relationship was mediated by disease severity, catastrophizing and mood status. Conclusion: Results showed a significant relationship between Type D personality and QOL. However, when the variables were added to the model, the relationship ceased to exist. These results suggest that personality traits are indirectly associated with QOL, mediated by another variable.

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