Outcome measures assisting treatment optimization in multiple sclerosis

Objective To review instruments used to assess disease stability or progression in persons with multiple sclerosis (pwMS) that can guide clinicians in optimizing therapy. Methods A non-systematic review of scientific literature was undertaken to explore modalities of monitoring symptoms and the disease evolution of MS. Results Multiple outcome measures, or tools, have been developed for use in MS research as well as for the clinical management of pwMS. Beginning with the Expanded Disability Status Scale, introduced in 1983, clinicians and researchers have developed monitoring modalities to assess all aspects of MS and the neurological impairment it causes. Conclusions Much progress has been made in recent decades for the management of MS and for the evaluation of disease progression. New technology, such as wearable sensors, will provide new opportunities to better understand changes in function, dexterity, and cognition. Essential work over the decades since EDSS was introduced continues to improve our ability to treat this debilitating disease.

Post-viral mental health sequelae: Systematic review and meta-analysis of prevalence proportions

Background: Mental health problems (MHP) in COVID-19 patients and survivors were anticipated already during early stages of this pandemic. We aimed to synthesize the prevalence of anxiety, depression, post-traumatic and general distress of major virus epidemics since 2002. Methods: In this systematic review and meta-analysis, we searched PubMed, PsycINFO, and Embase from 2002 until April 14, 2021 for peer-reviewed studies reporting prevalence of MHP in adults with laboratory-confirmed or suspected SARS-CoV-1, H1N1, MERS-CoV, H7N9, Ebolavirus, or SARS-CoV-2 infection. We included studies that assessed MHP with well-validated and frequently used scales. A three-level random-effects meta-analysis for dependent sizes was conducted to account for multiple outcome reporting. We pooled MHP jointly and separately for mild or moderate-to-severe severity by acute (one month), ongoing (one to three month), and post-illness phase (longer than three months). A meta-regression was conducted to test for moderating effects. PROSPERO registration: CRD42020194535. Findings: We identified 59 studies providing a total of 187 effect sizes. Range for sample size (n=14-n=1002), females (22-79%), and mean age (32-72 years). MHP prevalence was higher for mild (35.5-46.3%) compared to moderate-to-severe MPH (17.3-22.3). MHP, in general, decreased from acute to post-illness from 46.3% to 38.8% and for mild and moderate-to-severe from 22.3% to 18.8%, respectively. We found no evidence of moderating effects except for non-random sampling and H1N1 showing higher proportions. Interpretation: MHP decreased over time but were still on a substantial level at post-illness. This highlights a need for rapid access to mental health care and rehabilitation planning in affected individuals.

Assessing Change in Intervention Research: The Benefits of Composite Outcomes

Intervention research is often time- and resource-intensive, with numerous participants involved over extended periods of time. To maximize the value of intervention studies, multiple outcome measures are often included, either to ensure a diverse set of outcomes is being assessed or to refine assessments of specific outcomes. Here, we advocate for combining assessments, rather than relying on individual measures assessed separately, to better evaluate the effectiveness of interventions. Specifically, we argue that by pooling information from individual measures into a single outcome, composite scores can provide finer estimates of the underlying theoretical construct of interest while retaining important properties more sophisticated methods often forgo, such as transparency and interpretability. We describe different methods to compute, evaluate, and use composites depending on the goals, design, and data. To promote usability, we also provide a preregistration template that includes examples in the context of psychological interventions with supporting R code. Finally, we make a number of recommendations to help ensure that intervention studies are designed in a way that maximizes discoveries. A Shiny app and detailed R code accompany this article and are available at https://osf.io/u96em/ .

Agile, Traditional, and Hybrid Approaches to Project Success: Is Hybrid a Poor Second Choice?

Three project management approaches—traditional, agile, and hybrid—were considered in this study. Results from an international study, including 477 cross-industry projects, indicated that 52% of projects could be categorized as hybrid approaches. A regression analysis using multiple outcome measures indicated substantial explanatory power (0.21 < R 2 <0.41). Analysis suggested that hybrid and agile approaches significantly increase stakeholder success over traditional approaches while achieving the same budget, time, scope, and quality outcomes. Hybrid approaches were found to be similar in effectiveness to fully agile approaches. Results validate decisions by practitioners to combine agile and traditional practices and suggest that hybrid is a leading project management approach.