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验证一种新的基于网络的方法,以捕捉多发性硬化症中的疾病进展结果。

Validating a novel web-based method to capture disease progression outcomes in multiple sclerosis.

机构信息

Barts and the London School of Medicine and Dentistry, Blizard Institute, Queen Mary University of London, 4 Newark Street, London, E1 2AT, UK.

出版信息

J Neurol. 2013 Oct;260(10):2505-10. doi: 10.1007/s00415-013-7004-1. Epub 2013 Jun 27.

Abstract

The Expanded Disability Status Scale (EDSS) is the current 'gold standard' for monitoring disease severity in multiple sclerosis (MS). The EDSS is a physician-based assessment. A patient-related surrogate for the EDSS may be useful in remotely capturing information. Eighty-one patients (EDSS range 0-8) having EDSS as part of clinical trials were recruited. All patients carried out the web-based survey with minimal assistance. Full EDSS scores were available for 78 patients. The EDSS scores were compared to those generated by the online survey using analysis of variance, matched pair test, Pearson's coefficient, weighted kappa coefficient, and the intra-class correlation coefficient. The internet-based EDSS scores showed good correlation with the physician-measured assessment (Pearson's coefficient = 0.85). Weighted kappa for full agreement was 0.647. Full agreement was observed in 20 patients who had EDSS scores ranging from 0 to 6; many of those with 100 % agreement had scores of 5.5-6 (n = 8).The intra-class coefficient was 0.844 overall for all cases. Internet-based FS and EDSS show good agreement with physician-measured scores. Agreement was better in patients with higher scores. Overall patient satisfaction with the web-based assessment was high. An internet-based assessment tool is likely to prove an invaluable tool in the long-term monitoring in MS.

摘要

扩展残疾状况量表(EDSS)是目前监测多发性硬化症(MS)疾病严重程度的“金标准”。EDSS 是一种基于医生的评估。患者相关的 EDSS 替代指标可能有助于远程获取信息。招募了 81 名(EDSS 范围为 0-8)正在进行临床试验且 EDSS 作为评估一部分的患者。所有患者均在最少帮助下进行了基于网络的调查。78 名患者的 EDSS 评分均可用。使用方差分析、配对检验、Pearson 相关系数、加权 Kappa 系数和组内相关系数比较了 EDSS 评分和在线调查生成的评分。基于互联网的 EDSS 评分与医生测量的评估结果具有良好的相关性(Pearson 相关系数=0.85)。完全一致的加权 Kappa 值为 0.647。在 EDSS 评分范围为 0 至 6 的 20 名患者中观察到完全一致;其中许多完全一致的患者得分在 5.5-6(n=8)。所有病例的组内系数总体为 0.844。基于互联网的 FS 和 EDSS 与医生测量的评分具有良好的一致性。评分较高的患者一致性更好。总体上,患者对基于网络的评估非常满意。基于互联网的评估工具很可能成为 MS 长期监测中非常有价值的工具。

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