TY - JOUR
T1 - Physical and Cognitive Functioning After 3 Years Can Be Predicted Using Information From the Diagnostic Process in Recently Diagnosed Multiple Sclerosis
AU - de Groot, V.
AU - Beckerman, H.
AU - Uitdehaag, B.M.J.
AU - Hintzen, R.Q.
AU - Minneboo, A.
AU - Heymans, M.W.
AU - Lankhorst, G.J.
AU - Polman, C.H.
AU - Bouter, L.M.
N1 - J English Article de Groot, V, Vrije Univ Amsterdam Med Ctr, Dept Rehabil Med, POB 7057, NL-1007 MB Amsterdam, Netherlands v.degroot@vumc.nl 46 0 W B SAUNDERS CO-ELSEVIER INC PHILADELPHIA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SEP Discipline: Rehabilitation; Sport Sciences 496AA
PY - 2009
Y1 - 2009
N2 - de Groot V, Beckerman H, Uitdehaag BM, Hintzen RQ, Minneboo A, Heymans MW, Lankhorst GJ, Polman CH, Bouter LM, on behalf of the Functional Prognostication and Disability (FuPro) Study Group. Physical and cognitive functioning after 3 years can be predicted using information from the diagnostic process in recently diagnosed multiple sclerosis. Objective: To predict functioning after 3 years in patients with recently diagnosed multiple sclerosis (MS). Design: Inception cohort with 3 years of follow-up. At baseline, predictors were obtained from medical history taking, neurologic examination, and magnetic resonance imaging (MRI). Setting: Neurology outpatient clinic. Participants: Patients with MS (N=156); 146 with complete follow-up. Interventions: Not applicable. Main Outcome Measures: Inability to walk at least 500m, impaired dexterity, cognitive impairments, incontinence, inability to drive a car or use public transportation, social dysfunction, and reliance on a disability pension. Results: Clinical prediction rules were constructed for the models that were well calibrated (sufficient agreement between predicted and observed outcomes, based on visual inspection of calibration curves) and that showed sufficient discrimination (area under the receiver operation characteristic curve >.70) after internal bootstrap validation. The models for the inability to walk at least 500m, impaired dexterity, and cognitive impairments were well calibrated. Discrimination was sufficient for all 7 models, except the one predicting social dysfunction (.67). The inability to walk at least 500m was predicted by the perceived ability to walk, impairment of the cerebellar tract, and the number of MRI lesions in the spinal cord. Impaired dexterity was predicted by the perceived ability to use the hands, impairments of the pyramidal, cerebellar, and sensory tracts, and the T2-weighted infratentorial lesion load. Cognitive impairment was predicted by age, gender, the perceived ability to concentrate, and the T2-weighted supratentorial lesion load. Conclusions: Inability to walk at least 500m, impaired dexterity, and cognitive impairments can be predicted with predictors that are derived from medical history taking, neurologic examination, and MRI shortly after a definite diagnosis of MS has been made. © 2009 American Congress of Rehabilitation Medicine.
AB - de Groot V, Beckerman H, Uitdehaag BM, Hintzen RQ, Minneboo A, Heymans MW, Lankhorst GJ, Polman CH, Bouter LM, on behalf of the Functional Prognostication and Disability (FuPro) Study Group. Physical and cognitive functioning after 3 years can be predicted using information from the diagnostic process in recently diagnosed multiple sclerosis. Objective: To predict functioning after 3 years in patients with recently diagnosed multiple sclerosis (MS). Design: Inception cohort with 3 years of follow-up. At baseline, predictors were obtained from medical history taking, neurologic examination, and magnetic resonance imaging (MRI). Setting: Neurology outpatient clinic. Participants: Patients with MS (N=156); 146 with complete follow-up. Interventions: Not applicable. Main Outcome Measures: Inability to walk at least 500m, impaired dexterity, cognitive impairments, incontinence, inability to drive a car or use public transportation, social dysfunction, and reliance on a disability pension. Results: Clinical prediction rules were constructed for the models that were well calibrated (sufficient agreement between predicted and observed outcomes, based on visual inspection of calibration curves) and that showed sufficient discrimination (area under the receiver operation characteristic curve >.70) after internal bootstrap validation. The models for the inability to walk at least 500m, impaired dexterity, and cognitive impairments were well calibrated. Discrimination was sufficient for all 7 models, except the one predicting social dysfunction (.67). The inability to walk at least 500m was predicted by the perceived ability to walk, impairment of the cerebellar tract, and the number of MRI lesions in the spinal cord. Impaired dexterity was predicted by the perceived ability to use the hands, impairments of the pyramidal, cerebellar, and sensory tracts, and the T2-weighted infratentorial lesion load. Cognitive impairment was predicted by age, gender, the perceived ability to concentrate, and the T2-weighted supratentorial lesion load. Conclusions: Inability to walk at least 500m, impaired dexterity, and cognitive impairments can be predicted with predictors that are derived from medical history taking, neurologic examination, and MRI shortly after a definite diagnosis of MS has been made. © 2009 American Congress of Rehabilitation Medicine.
U2 - https://doi.org/10.1016/j.apmr.2009.03.018
DO - https://doi.org/10.1016/j.apmr.2009.03.018
M3 - Article
C2 - 19735774
SN - 0003-9993
VL - 90
SP - 1478
EP - 1488
JO - Archives of physical medicine and rehabilitation
JF - Archives of physical medicine and rehabilitation
IS - 9
ER -