Currently Viewing:
Newsroom
Currently Reading
What Is the Smallest Change in Arm Function That Patients With MS Find Meaningful?
February 28, 2019 – Laura Joszt
Patients With MS Face Substantial, but Differing, Burdens in Japan, EU, and US
February 19, 2019 – Laura Joszt
Polypharmacy Plays a Role in Patients With Relapsing-Remitting Multiple Sclerosis
February 17, 2019 – Laura Joszt
Continuous Fingolimod Treatment Leads to 50% Reduction of ARRs
February 15, 2019 – Samantha DiGrande
Insurance Guidelines Lead to Greater Out-of-Pocket Costs for Patients With MS
February 09, 2019 – Samantha DiGrande
Assessing Aspects of Burden in Caregivers of Patients With Multiple Sclerosis
February 08, 2019 – Laura Joszt
Fingolimod Significantly Reduces Relapse in MS Compared With Dimethyl Fumarate, Teriflunomide
February 01, 2019 – Samantha DiGrande
Researchers Identify New Therapeutic Approach to Multiple Sclerosis With Sephin1
January 30, 2019 – Laura Joszt
Factors Associated With Speed of Multiple Sclerosis Diagnosis
January 26, 2019 – Laura Joszt

What Is the Smallest Change in Arm Function That Patients With MS Find Meaningful?

Laura Joszt
A new study determines the smallest change in upper extremity function that patients with multiple sclerosis (MS) find important or meaningful through an analysis in the change of scores of the Arm Functiom in Multiple Sclerosis Questionnaire.
What change in the ability to walk or in upper-limb function do patients with multiple sclerosis (MS) find important? There are not many ways to measure such a change.

The ability to walk without help and upper extremity function (UEF) are domains that are assessed in patients with MS, but among the measures available, only one, the Arm Function in Multiple Sclerosis Quiestionnaire (AMSQ), uses patient-reported outcomes. In a study published in Multiple Sclerosis Journal, researchers sought to determine the minimal clinically important difference (MCID), which defines the smallest change that the patient would find important or meaningful.

“Determining an MCID of a [patient-reported outcome measure] is important because a given change on the score generally does not have an obvious clinical importance to the clinician,” the authors explained.

A total of 223 patients who were treated with fampridine were recruited at the VU Medical Center in Amsterdam. More than half (56.5%) had a progressive disease type, the median disease duration was 11.4 years, and the median Expanded Disability Status Scale score 6.0. Fampridine is supposed to improve various motor functions, generally within 2 weeks of treatment. The patients completed the AMSQ before treatment and during a follow-up visit that took place at least 2 weeks after treatment.

The AMSQ includes 31 items related to hand and arm functioning, and patients assign a number to each item. The final score ranges from 31 (indicating no limitations) to 186 (indicating no function). The researchers calculated the change in the score by substracting the follow-up AMSQ score from the baseline score. A positive score indicated an improvement in UEF.

Then, the researchers use a global perceived effect (GPE) score that addressed change in UEF and was determined by the physician during the follow-up visit taking place at least 2 weeks after treatment. The GPE scores were divided into either “improved” or “unchanged.” They determined the AMSQ score that produced the greatest combined sensitivity and specificity through a received operating characteristic curve. This was the MCID.

The MCID value for the AMSQ was 15 points, meaning a 15-point change in AMSQ score, which has a range of 31 to 186, was the smallest change in function that patients found meaningful.

“Future studies should investigate reproducibility of this finding with similar and other methods, in a cohort with extensive assessment of different domains of UEF,” the authors concluded.

Reference

van Munster CE, Kaya L, Obura M, Kalkers NF, Uitdehaag BM. Minimal clinically important difference of improvement on the Arm Function in Multiple Sclerosis Questionnaire (AMSQ) [published online January 18, 2019]. Mult Scler. doi: 10.1177/1352458518823489.

Related Articles

High Disability Levels in MS Associated With Higher Costs, Lower Quality of Life
Perceptions of Patients With MS and Caregivers on Daily Activity Performance
Understanding the Relationship Among Fatigue, Sleep Hygiene Behaviors, and Symptoms of Multiple Sclerosis
Assessing Aspects of Burden in Caregivers of Patients With Multiple Sclerosis
 
Copyright AJMC 2006-2020 Clinical Care Targeted Communications Group, LLC. All Rights Reserved.
x
Welcome the the new and improved AJMC.com, the premier managed market network. Tell us about yourself so that we can serve you better.
Sign Up