PMID- 34333756
OWN - NLM
STAT- MEDLINE
DCOM- 20210915
LR  - 20220218
IS  - 1865-8652 (Electronic)
IS  - 0741-238X (Print)
IS  - 0741-238X (Linking)
VI  - 38
IP  - 9
DP  - 2021 Sep
TI  - Creating a Real-World Data, United States Healthcare Claims-Based Adaptation of 
      Kurtzke Functional Systems Scores for Assessing Multiple Sclerosis Severity and 
      Progression.
PG  - 4786-4797
LID - 10.1007/s12325-021-01858-9 [doi]
AB  - INTRODUCTION: This article describes the development of a unique mapping of the 
      Kurtzke Functional Systems Scores (KFSS) from International Classification of 
      Diseases, 9th revision, Clinical Modification (ICD-9-CM) codes among multiple 
      sclerosis (MS) patients within a US Integrated Delivery Network (IDN). Valid 
      identification of increasing disability may allow deeper insight into 
      MS progression and possible treatments. METHODS: This cohort study identified MS 
      patients in the IDN, Intermountain Healthcare. Experienced clinicians and 
      informaticists mapped electronic health record ICD-9-CM codes to KFSS components 
      generating a modified Kurtzke Expanded Disability Status Scale (EDSS). Modified 
      EDSS scores were used to assess disability progression by calculating means, 
      medians, ranges, and changes in KFSS and modified EDSS scores. RESULTS: Overall, 
      608/2960 (20.5%) patients were identified as having MS progression and presented 
      a wide range of scores on the EDSS 10-point scale. The median (range) first and 
      second EDSS scores were 0 (0-6) and 5 (1-8), respectively. The median (range) 
      change from first to second score was 5 (1-7.5). The median first KFSS score for 
      all systems was 0, and the mean differed among components. The highest mean first 
      KFSS score (1.06) was measured for sensory function and lowest (0.12) for 
      cerebellar functions. Of the 544 patients with their first EDSS scores in 
      the </= 2.5 group, 75.2% and 15.1% had their second EDSS scores in group 3-5.5 
      and >/= 6, respectively. Of the 62 patients with their first EDSS score in the 
      3-5.5 group, 58.1% had their second EDSS scores in group >/= 6. CONCLUSION: This 
      innovative mapping technique is a promising method for future comparative 
      effectiveness and safety research of Disease-Modifying Therapy in Real-World Data 
      repositories. Future research to validate and expand on this method in another 
      healthcare database is encouraged.
CI  - (c) 2021. The Author(s).
FAU - Truong, Chi T L
AU  - Truong CTL
AD  - MedCodeWorld, Chapel Hill, NC, USA.
FAU - Le, Hoa V
AU  - Le HV
AD  - PAREXEL International, 2520 Meridian Pkwy #200, Durham, NC, 27713, USA. 
      hoa.vanle@gmail.com.
FAU - Kamauu, Aaron W
AU  - Kamauu AW
AD  - PAREXEL, Bountiful, UT, USA.
FAU - Holmen, John R
AU  - Holmen JR
AD  - Intermountain Healthcare, Murray, UT, USA.
FAU - Fillmore, Christopher L
AU  - Fillmore CL
AD  - Intermountain Healthcare, Murray, UT, USA.
FAU - Kobayashi, Monica G
AU  - Kobayashi MG
AD  - PAREXEL, Durham, NC, USA.
FAU - Wong, Schiffon L
AU  - Wong SL
AD  - EMD Serono, Billerica, MA, USA.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210731
PL  - United States
TA  - Adv Ther
JT  - Advances in therapy
JID - 8611864
MH  - Cohort Studies
MH  - Databases, Factual
MH  - Delivery of Health Care
MH  - Disability Evaluation
MH  - Disease Progression
MH  - Health Services
MH  - Humans
MH  - *Multiple Sclerosis/diagnosis
MH  - United States
PMC - PMC8408077
OTO - NOTNLM
OT  - Algorithm
OT  - EDSS
OT  - ICD-9 mapping
OT  - KFSS
OT  - MS disability
OT  - Real-world data
EDAT- 2021/08/02 06:00
MHDA- 2021/09/16 06:00
PMCR- 2021/07/31
CRDT- 2021/08/01 21:15
PHST- 2021/01/29 00:00 [received]
PHST- 2021/07/13 00:00 [accepted]
PHST- 2021/08/02 06:00 [pubmed]
PHST- 2021/09/16 06:00 [medline]
PHST- 2021/08/01 21:15 [entrez]
PHST- 2021/07/31 00:00 [pmc-release]
AID - 10.1007/s12325-021-01858-9 [pii]
AID - 1858 [pii]
AID - 10.1007/s12325-021-01858-9 [doi]
PST - ppublish
SO  - Adv Ther. 2021 Sep;38(9):4786-4797. doi: 10.1007/s12325-021-01858-9. Epub 2021 
      Jul 31.