Abstract:
BACKGROUND:There is increasing emphasis on using patient-reported outcomes (PROs) to complement traditional clinical outcomes in medical research, including in multiple sclerosis (MS). Research, particularly in oncology and heart failure, has shown that PROs can be prognostic of hard clinical endpoints such as survival time (time from study entry until death). However, unlike in oncology or cardiology, it is unknown whether PROs are associated with survival time in neurological diseases. The Multiple Sclerosis Impact Scale-29 (MSIS-29) is a PRO sensitive to short-term change in MS, with questions covering both physical and psychological quality of life. This study aimed to investigate whether MSIS-29 scores can be prognostic for survival time in MS, using a large observational cohort of people with MS. METHODS AND FINDINGS:From 15 July 2004 onwards, MSIS-29 questionnaires were completed by people with MS registered with the MS Society Tissue Bank (n = 2,126, repeated 1 year later with n = 872 of the original respondents). By 2014, 264 participants (12.4%) had died. Higher baseline MSIS-29 physical (MSIS-29-PHYS) score was associated with reduced survival time (subgroup with highest scores versus subgroup with lowest scores: hazard ratio [HR] 5.7, 95% CI 3.1-10.5, p < 0.001). Higher baseline MSIS-29 psychological score was also associated with reduced survival time (subgroup with highest scores versus subgroup with lowest scores: HR 2.8, 95% CI 1.8-4.4, p < 0.001). In those with high baseline MSIS-29 scores, mortality risk was even greater if the MSIS-29 score worsened over 1 year (HR 2.3, 95% CI 1.2-4.4, p = 0.02). MSIS-29-PHYS scores were associated with survival time independent of age, sex, and patient-reported Expanded Disability Status Scale score in a Cox regression analysis (per 1-SD increase in MSIS-29-PHYS score: HR 1.8, 95% CI 1.1-2.9, p = 0.03). A limitation of the study is that this cohort had high baseline age and disability levels; the prognostic value of MSIS-29 for survival time at earlier disease stages requires further investigation. CONCLUSIONS:This study reports that PROs can be prognostic for hard clinical outcomes in neurological disease, and supports PROs as a meaningful clinical outcome for use in research and clinical settings.
journal_name
PLoS Medjournal_title
PLoS medicineauthors
Raffel J,Wallace A,Gveric D,Reynolds R,Friede T,Nicholas Rdoi
10.1371/journal.pmed.1002346subject
Has Abstractpub_date
2017-07-10 00:00:00pages
e1002346issue
7eissn
1549-1277issn
1549-1676pii
PMEDICINE-D-17-00101journal_volume
14pub_type
杂志文章相关文献
PLOS MEDICINE文献大全abstract:BACKGROUND:Through major efforts to reduce costs and expand access to antiretroviral therapy worldwide, widespread delivery of effective treatment to people living with HIV/AIDS is now conceivable even in severely resource-constrained settings. However, the potential epidemiologic impact of treatment in the context of ...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.0020016
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Although gastric cancer has declined dramatically in the US, the disease remains the second leading cause of cancer mortality worldwide. A better understanding of reasons for the decline can provide important insights into effective preventive strategies. We sought to estimate the contribution of risk factor...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1001451
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND TO THE DEBATE:Umbilical cord blood--the blood that remains in the placenta after birth--can be collected and stored frozen for years. A well-accepted use of cord blood is as an alternative to bone marrow as a source of hematopoietic stem cells for allogeneic transplantation to siblings or to unrelated recipi...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.0020044
更新日期:2005-02-01 00:00:00
abstract:BACKGROUND:Perinatal mortality and morbidity continue to be major global health challenges strongly associated with prematurity and reduced fetal growth, an issue of further interest given the mounting evidence that fetal growth in general is linked to degrees of risk of common noncommunicable diseases in adulthood. Ag...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1002220
更新日期:2017-01-24 00:00:00
abstract::In this Perspective on the clinical trial by Rita Alloway and colleagues, Simon Ball explains the benefits to healthcare systems and individual patients of the bioequivalence established between generic and brand-name formulations of an immunosuppressive drug in transplant recipients. ...
journal_title:PLoS medicine
pub_type: 评论,杂志文章
doi:10.1371/journal.pmed.1002429
更新日期:2017-11-14 00:00:00
abstract:BACKGROUND:Breast cancer is a leading malignancy affecting the female population worldwide. Most morbidity is caused by metastases that remain incurable to date. TGF-β1 has been identified as a key driving force behind metastatic breast cancer, with promising therapeutic implications. METHODS AND FINDINGS:Employing im...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1001871
更新日期:2015-09-01 00:00:00
abstract::In an Editorial accompanying PLOS Medicine's Special Issue on Diabetes Prevention, Guest Editors Nicholas Wareham and William Herman discuss some of the challenges for researchers and policy makers in developing effective and equitable solutions to the worldwide problem of type 2 diabetes. ...
journal_title:PLoS medicine
pub_type: 社论
doi:10.1371/journal.pmed.1002097
更新日期:2016-07-26 00:00:00
abstract:BACKGROUND:It has been suggested throughout the past fifty years that serum uric acid concentrations can help predict the future risk of coronary heart disease (CHD), but the epidemiological evidence is uncertain. METHODS AND FINDINGS:We report a "nested" case-control comparison within a prospective study in Reykjavik...
journal_title:PLoS medicine
pub_type: 杂志文章,meta分析
doi:10.1371/journal.pmed.0020076
更新日期:2005-03-01 00:00:00
abstract:BACKGROUND:Chronic kidney disease (CKD) is a major health issue for HIV-positive individuals, associated with increased morbidity and mortality. Development and implementation of a risk score model for CKD would allow comparison of the risks and benefits of adding potentially nephrotoxic antiretrovirals to a treatment ...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1001809
更新日期:2015-03-31 00:00:00
abstract::Diarrhea morbidity and mortality remain important child health problems in low- and middle-income countries. The treatment of diarrhea and accurate measurement of treatment coverage are critical if child mortality is going to continue to decline. In this review, we examine diarrhea treatment coverage indicators collec...
journal_title:PLoS medicine
pub_type: 杂志文章,评审
doi:10.1371/journal.pmed.1001385
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:The standard approaches to diagnosing autism spectrum disorder (ASD) evaluate between 20 and 100 behaviors and take several hours to complete. This has in part contributed to long wait times for a diagnosis and subsequent delays in access to therapy. We hypothesize that the use of machine learning analysis o...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1002705
更新日期:2018-11-27 00:00:00
abstract:BACKGROUND:Global data indicate that women with a history of hyperglycemia first detected in pregnancy (HFDP) are at up to 7 times risk of progressing to type 2 diabetes mellitus (T2DM) compared with their counterparts who have pregnancies that are not complicated by hyperglycemia. However, there are no data from the s...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1002865
更新日期:2019-09-09 00:00:00
abstract:BACKGROUND:Fibre is promoted as part of a healthy dietary pattern and in diabetes management. We have considered the role of high-fibre diets on mortality and increasing fibre intake on glycaemic control and other cardiometabolic risk factors of adults with prediabetes or diabetes. METHODS AND FINDINGS:We conducted a ...
journal_title:PLoS medicine
pub_type: 杂志文章,meta分析
doi:10.1371/journal.pmed.1003053
更新日期:2020-03-06 00:00:00
abstract::Hannah Leslie and co-authors discuss priorities in individual countries for health system reform. ...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1002946
更新日期:2019-10-03 00:00:00
abstract:BACKGROUND:Since 1998 the serious public health problem in South East Asia of counterfeit artesunate, containing no or subtherapeutic amounts of the active antimalarial ingredient, has led to deaths from untreated malaria, reduced confidence in this vital drug, large economic losses for the legitimate manufacturers, an...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.0050032
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:The SARS outbreak of 2002-2003 presented clinicians with a new, life-threatening disease for which they had no experience in treating and no research on the effectiveness of treatment options. The World Health Organization (WHO) expert panel on SARS treatment requested a systematic review and comprehensive s...
journal_title:PLoS medicine
pub_type: 杂志文章,评审
doi:10.1371/journal.pmed.0030343
更新日期:2006-09-01 00:00:00
abstract::In a Policy Forum, Peter Hotez and colleagues discuss vaccination exemptions in US states and possible consequences for infectious disease outbreaks. ...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1002578
更新日期:2018-06-12 00:00:00
abstract:BACKGROUND:Standardised packaging (SP) of tobacco products is an innovative tobacco control measure opposed by transnational tobacco companies (TTCs) whose responses to the UK government's public consultation on SP argued that evidence was inadequate to support implementing the measure. The government's initial decisio...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1001629
更新日期:2014-03-25 00:00:00
abstract:BACKGROUND:Skin atrophy is a common manifestation of aging and is frequently accompanied by ulceration and delayed wound healing. With an increasingly aging patient population, management of skin atrophy is becoming a major challenge in the clinic, particularly in light of the fact that there are no effective therapeut...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.0030493
更新日期:2006-12-01 00:00:00
abstract::Aaron Kesselheim and colleagues examine orphan-designated drugs approved between 2009 and 2015 in the United States. ...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1002190
更新日期:2017-01-03 00:00:00
abstract:BACKGROUND:Bariatric and metabolic surgery is used as a treatment for patients with severe and complex obesity. However, there is a need to improve outcome selection and reporting in bariatric surgery trials. A Core Outcome Set (COS), an agreed minimum set of outcomes reported in all studies of a specific condition, ma...
journal_title:PLoS medicine
pub_type: 指南,杂志文章
doi:10.1371/journal.pmed.1002187
更新日期:2016-11-29 00:00:00
abstract:BACKGROUND:The response to the next influenza pandemic will likely include extensive use of antiviral drugs (mainly oseltamivir), combined with other transmission-reducing measures. Animal and in vitro studies suggest that some strains of influenza may become resistant to oseltamivir while maintaining infectiousness (f...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.0040015
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:Malaria vaccines based on the 19-kDa region of merozoite surface protein 1 (MSP-1(19)) derived from the 3D7 strain of Plasmodium falciparum are being tested in clinical trials in Africa. Knowledge of the distribution and natural dynamics of vaccine antigen polymorphisms in populations in which malaria vaccin...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.0040093
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:We simulated tobacco control and pharmacological strategies for preventing cardiovascular deaths in India, the country that is expected to experience more cardiovascular deaths than any other over the next decade. METHODS AND FINDINGS:A microsimulation model was developed to quantify the differential effect...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1001480
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Immunohistochemical markers are often used to classify breast cancer into subtypes that are biologically distinct and behave differently. The aim of this study was to estimate mortality for patients with the major subtypes of breast cancer as classified using five immunohistochemical markers, to investigate ...
journal_title:PLoS medicine
pub_type: 杂志文章,meta分析
doi:10.1371/journal.pmed.1000279
更新日期:2010-05-25 00:00:00
abstract:BACKGROUND:Resistance of malaria parasites to chloroquine (CQ) and sulphadoxine-pyrimethamine (SP) is increasing in prevalence in Africa. Combination therapy can both improve treatment and provide important public health benefits if it curbs the spread of parasites harbouring resistance genes. Thus, drug combinations m...
journal_title:PLoS medicine
pub_type: 杂志文章,随机对照试验
doi:10.1371/journal.pmed.0020092
更新日期:2005-04-01 00:00:00
abstract:BACKGROUND:Diabetes is a well-known risk factor for tuberculosis (TB) and is increasingly prevalent in low- and middle-income countries, where the burden of TB is high. Glycemic control has the potential to modify the risk of TB. However, there are few studies on the association between glycemic control and TB risk, an...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1002072
更新日期:2016-08-09 00:00:00
abstract:BACKGROUND:Bariatric surgery is becoming a more widespread treatment for obesity. Comprehensive evidence of the long-term effects of contemporary surgery on a broad range of clinical outcomes in large populations treated in routine clinical practice is lacking. The objective of this study was to measure the association...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1001925
更新日期:2015-12-22 00:00:00
abstract:BACKGROUND:To reduce the risk of drug-induced haemolysis, all patients should be tested for glucose-6-phosphate dehydrogenase (G6PD) deficiency (G6PDd) prior to prescribing primaquine (PQ)-based radical cure for the treatment of vivax malaria. This systematic review and individual patient meta-analysis assessed the uti...
journal_title:PLoS medicine
pub_type: 杂志文章,meta分析
doi:10.1371/journal.pmed.1002992
更新日期:2019-12-13 00:00:00
abstract::On the 30th anniversary of the Chernobyl disaster, Amina Aitsi-Selmi and Virginia Murray reflect on the importance of disaster preparedness. ...
journal_title:PLoS medicine
pub_type: 历史文章,杂志文章
doi:10.1371/journal.pmed.1002017
更新日期:2016-04-25 00:00:00