Gasperini et al reported the RoAD score for estimating the 10-year risk of ambulatory disability for a patient with multiple sclerosis. The authors are from San Camillo-Forlanini Hospital (Rome), Universitat Autonoma de Barcelona, ASST SPedali Civili di Brescia and Sapienza University in Rome.
Patient selection: multiple sclerosis
Parameters:
(1) age in years at the start of initial treatment
(2) time in years between the first symptom of MS and the start of treatment
(3) EDSS score at the start of treatment
(4) number of relapses in the first year after starting treatment
(5) number of gadolinium-enhancing lesions after the first of treatment
(6) number of new T2 lesions in the first year after starting therapy
Parameter
Finding
Points
age in years
< 40 years
0
>= 40 years
1
time since first symptom
< 2 years
0
>= 2 years
1
EDSS score
< 1.5
0
1.5 to 2.0
1
>= 2.5
2
number of relapses
0
0
1
1
>= 2
2
number of gandolinium enhancing lesions
0 or 1
0
>= 2
1
number of new T2 lesions
0 to 2
0
>= 3
1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 8
• A score >= 4 was associated with a higher risk of ambulatory disability (HR 4.2). For a score < 4 the disability-free survival at 10 years was 93% vs 73% if score >= 4.
Total Score
Disability at 10 years
0
0%
1 or 2
1-9%
3 or 4
20-28%
5 or 6
36-66%
7 or 8
85 to 100%
Performance:
• The area under the ROC curve is 0.86.
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