Validation of the SymptoMScreen with performance-based or clinician-assessed outcomes.


Journal

Multiple sclerosis and related disorders
ISSN: 2211-0356
Titre abrégé: Mult Scler Relat Disord
Pays: Netherlands
ID NLM: 101580247

Informations de publication

Date de publication:
Apr 2019
Historique:
received: 03 10 2018
revised: 31 12 2018
accepted: 23 01 2019
pubmed: 29 1 2019
medline: 17 7 2019
entrez: 29 1 2019
Statut: ppublish

Résumé

People with multiple sclerosis (MS) experience symptoms in multiple domains. High-quality patient-reported outcomes (PROs) that assess multiple domains can aid healthcare providers in assessing these symptoms and may support remote disease monitoring. The "SymptoMScreen" PRO correlates with other PROs in MS; however, whether the SymptoMScreen or its component domains are associated with performance-based or clinician-assessed outcomes is unknown. To validate SymptoMScreen and its domains against performance-based, clinician-assessed measures or other well-validated diagnostic tools. We recruited participants with MS from a large tertiary care center. At routine clinic visits participants completed the MS performance test (MSPT), which is an iPad-based application that objectively assesses walking speed, manual dexterity, processing speed, and low contrast letter acuity. Expanded Disability Status Scale (EDSS) scores were assessed in a subset. Participants also completed an online SymptoMScreen following clinic visits. We assessed criterion and construct validity by calculating Spearman rank correlations between the 12 SymptoMScreen domains and respective clinical outcomes. We evaluated test-retest reliability using intra-class correlation coefficients [ICC], and internal consistency reliability using Cronbach's alpha. The 102 participants were predominantly female (78%), of average age [standard deviation]: 47.6 [12.3] years, with an average disease duration: 13.1 [10.0] years); 60 participants completed the SymptoMScreen and EDSS. Composite SymptoMScreen scores were associated with EDSS (r = 0.71; 95% CI 0.54, 0.83). For individual domains, strong correlations were observed between mobility scores and walking speed (r = 0.63; 95% CI: 0.48, 0.75) and hand function scores with manual dexterity (r = 0.52; 95% CI: 0.36, 0.65). More moderate correlations were detected for the cognition domain with processing speed (r=-0.37; 95% CI: -0.53, -0.18) and for the visual function domain with low contrast letter acuity at 2.5% contrast (r=-0.33; 95% CI -0.54, -0.08). Both test-retest and internal consistency reliability measures for overall SymptoMScreen scores were high (ICC: 0.88; 95% CI: 0.80, 0.93; Cronbach's alpha: 0.93; 95% CI: 0.90, 96). The SymptoMScreen is practical outcome measure whose subscales may provide a valid assessment of corresponding performance-based and clinician-assessed measures among people with MS with mild-to-moderate disability.

Sections du résumé

BACKGROUND BACKGROUND
People with multiple sclerosis (MS) experience symptoms in multiple domains. High-quality patient-reported outcomes (PROs) that assess multiple domains can aid healthcare providers in assessing these symptoms and may support remote disease monitoring. The "SymptoMScreen" PRO correlates with other PROs in MS; however, whether the SymptoMScreen or its component domains are associated with performance-based or clinician-assessed outcomes is unknown.
OBJECTIVES OBJECTIVE
To validate SymptoMScreen and its domains against performance-based, clinician-assessed measures or other well-validated diagnostic tools.
METHODS METHODS
We recruited participants with MS from a large tertiary care center. At routine clinic visits participants completed the MS performance test (MSPT), which is an iPad-based application that objectively assesses walking speed, manual dexterity, processing speed, and low contrast letter acuity. Expanded Disability Status Scale (EDSS) scores were assessed in a subset. Participants also completed an online SymptoMScreen following clinic visits. We assessed criterion and construct validity by calculating Spearman rank correlations between the 12 SymptoMScreen domains and respective clinical outcomes. We evaluated test-retest reliability using intra-class correlation coefficients [ICC], and internal consistency reliability using Cronbach's alpha.
RESULTS RESULTS
The 102 participants were predominantly female (78%), of average age [standard deviation]: 47.6 [12.3] years, with an average disease duration: 13.1 [10.0] years); 60 participants completed the SymptoMScreen and EDSS. Composite SymptoMScreen scores were associated with EDSS (r = 0.71; 95% CI 0.54, 0.83). For individual domains, strong correlations were observed between mobility scores and walking speed (r = 0.63; 95% CI: 0.48, 0.75) and hand function scores with manual dexterity (r = 0.52; 95% CI: 0.36, 0.65). More moderate correlations were detected for the cognition domain with processing speed (r=-0.37; 95% CI: -0.53, -0.18) and for the visual function domain with low contrast letter acuity at 2.5% contrast (r=-0.33; 95% CI -0.54, -0.08). Both test-retest and internal consistency reliability measures for overall SymptoMScreen scores were high (ICC: 0.88; 95% CI: 0.80, 0.93; Cronbach's alpha: 0.93; 95% CI: 0.90, 96).
CONCLUSIONS CONCLUSIONS
The SymptoMScreen is practical outcome measure whose subscales may provide a valid assessment of corresponding performance-based and clinician-assessed measures among people with MS with mild-to-moderate disability.

Identifiants

pubmed: 30690340
pii: S2211-0348(19)30037-9
doi: 10.1016/j.msard.2019.01.031
pii:
doi:

Types de publication

Journal Article Observational Study Validation Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

86-93

Informations de copyright

Copyright © 2019 Elsevier B.V. All rights reserved.

Auteurs

Kathryn C Fitzgerald (KC)

Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, United States. Electronic address: fitzgerald@jhmi.edu.

Amber Salter (A)

Division of Biostatistics, Washington University in St. Louis School of Medicine, St. Louis, MO, United States. Electronic address: amber@wustl.edu.

Tuula Tyry (T)

Dignity Health, St. Joseph's Hospital and Medical Center, Phoenix, AZ, United States. Electronic address: tuula.tyry@dignityhealth.org.

Robert J Fox (RJ)

Mellen Center for Multiple Sclerosis, Cleveland Clinic Foundation, Cleveland, OH, United States. Electronic address: foxr@ccf.org.

Gary Cutter (G)

Department of Biostatistics, University of Alabama in Birmingham School of Public Health, Birmingham, AL, United States. Electronic address: cutterg@uab.edu.

Ellen M Mowry (EM)

Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, United States. Electronic address: emowry1@jhmi.edu.

Ruth Ann Marrie (RA)

Department of Internal Medicine and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada. Electronic address: rmarrie@hsc.mb.ca.

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Classifications MeSH