Highlights
- •An evidence based online decision support tool for prognosis simulation is presented.
- •Relevant variables are synthesized in a comprehensive and easy to use model interface.
- •The onset of the secondary progressive phase and long-term disability are emphasized.
- •Model validation results are in line with the existing scientific evidence.
Abstract
A multiplicity of natural history studies of multiple sclerosis provides valuable
knowledge of the disease progression but individualized prognosis remains elusive.
A few decision support tools that assist the clinician in such task have emerged but
have not received proper attention from clinicians and patients. The objective of
the current work is to implement a web-based tool, conveying decision relevant prognostic
scientific evidence, which will help clinicians discuss prognosis with individual
patients. Data were extracted from a set of reference studies, especially those dealing
with the natural history of multiple sclerosis. The web-based decision support tool
for individualized prognosis simulation was implemented with NetLogo, a program environment
suited for the development of complex adaptive systems. Its prototype has been launched
online; it enables clinicians to predict both the likelihood of CIS to CDMS conversion,
and the long-term prognosis of disability level and SPMS conversion, as well as assess
and monitor the effects of treatment. More robust decision support tools, which convey
scientific evidence and satisfy the needs of clinical practice by helping clinicians
discuss prognosis expectations with individual patients, are required. The web-based
simulation model herein introduced proposes to be a step forward toward this purpose.
Keywords
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Article info
Publication history
Published online: May 02, 2014
Accepted:
April 22,
2014
Received in revised form:
April 14,
2014
Received:
December 16,
2013
Identification
Copyright
© 2014 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
