[0]期刊文章%@ 1438-8871 I JMIR出版物%V 22 卡塔尔世界杯8强波胆分析%N 2 %P e16932 %T医生完成的评估疾病进展的数字工具(多发性硬化进展讨论工具):验证研究%A Ziemssen,Tjalf %A Piani-Meier,Daniela %A Bennett,Bryan %A Johnson,Chloe %A Tinsley,Katie %A Trigg,Andrew %A Hach,Thomas %A Dahlke,Frank %A Tomic,Davorka %A Tolley,Chloe %A Freedman,Mark S %+临床神经科学中心，神经学大学卡尔·古斯塔夫·卡鲁斯诊所，德累斯顿工业大学，Fetscherstraße 74，德累斯顿，德国，49 351 458 4465，ziemssen@web.de %K多发性硬化症%K复发缓解型多发性硬化症%K继发进行性多发性硬化症%K过渡%K进展%K数字化%K验证%D 2020 %7背景:定义从复发缓解型多发性硬化症(RRMS)到继发进行性多发性硬化症(SPMS)的过渡可能具有挑战性和延迟性。一种数字工具(msprodiscussion)被开发出来，以促进医患讨论，以评估代表这种转变的多发性硬化症(MS)疾病进展的早期、微妙迹象。目的:本研究旨在确定包括或不包括扩展残疾状态量表(EDSS)评分的预定义评分算法的临界值和相应的灵敏度和特异性，以区分RRMS和SPMS患者，并评估心理测量学特征。方法:经验丰富的神经科医师对已确诊的RRMS或SPMS患者以及怀疑向SPMS过渡的患者完成该工具。除了年龄和EDSS评分外，在完成草稿工具时还收集了每位患者当前的疾病状态(疾病活动、症状及其对日常生活的影响)。受试者工作特征(ROC)曲线确定了RRMS和SPMS分类的最佳临界值(敏感性和特异性)。结果:20名神经科医生完成了198例患者的草稿工具。RRMS (n=89)、过渡到SPMS (n=47)和SPMS (n=62)患者的平均评分分别为38.1 (SD 12.5)、55.2 (SD 11.1)和69.6 (SD 12.0) (P< 0.05)。0.001，每组间比较)。 Area under the ROC curve (AUC) including and excluding EDSS were for RRMS (including) AUC 0.91, 95% CI 0.87-0.95, RRMS (excluding) AUC 0.88, 95% CI 0.84-0.93, SPMS (including) AUC 0.91, 95% CI 0.86-0.95, and SPMS (excluding) AUC 0.86, 95% CI 0.81-0.91. In the algorithm with EDSS, the optimal cut-off values were ≤51.6 for RRMS patients (sensitivity=0.83; specificity=0.82) and ≥58.9 for SPMS patients (sensitivity=0.82; specificity=0.84). The optimal cut-offs without EDSS were ≤46.3 and ≥57.8 and resulted in similar high sensitivity and specificity (0.76-0.86). The draft tool showed excellent interrater reliability (intraclass correlation coefficient=.95). Conclusions: The MSProDiscuss tool differentiated RRMS patients from SPMS patients with high sensitivity and specificity. In clinical practice, it may be a useful tool to evaluate early, subtle signs of MS disease progression indicating the evolution of RRMS to SPMS. MSProDiscuss will help assess the current level of progression in an individual patient and facilitate a more informed physician-patient discussion. %M 32049062 %R 10.2196/16932 %U //www.mybigtv.com/2020/2/e16932 %U https://doi.org/10.2196/16932 %U http://www.ncbi.nlm.nih.gov/pubmed/32049062