Consensus for the Early Identification of Secondary Progressive Multiple Sclerosis in Portugal: a Delphi Panel
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.17/4527 |
Resumo: | Introduction: Multiple sclerosis is a disease with a heterogeneous evolution. The early identification of secondary progressive multiple sclerosis is a clinical challenge, which would benefit from the definition of biomarkers and diagnostic tools applicable in the transition phase from relapsing-remitting multiple sclerosis to secondary progressive multiple sclerosis. We aimed to reach a Portuguese national consensus on the monitoring of patients with multiple sclerosis and on the more relevant clinical variables for the early identification of its progression. Material and methods: A Delphi panel which included eleven Portuguese Neurologists participated in two rounds of questions between July and August of 2021. In the first round, 39 questions which belonged to the functional, cognitive, imaging, biomarkers and additional evaluations were included. Questions for which no consensus was obtained in the first round (less than 80% of agreement), were appraised by the panel during the second round. Results: The response rate was 100% in both rounds and consensus was reached for a total of 33 questions (84.6%). Consensus was reached for monitoring time, evaluation scales and clinical variables such as the degree of brain atrophy and mobility reduction, changes suggestive of secondary progressive multiple sclerosis. Additionally, digital devices were considered tools with potential to identify disease progression. Most questions for which no consensus was obtained referred to the cognitive assessment and the remaining referred to both functional and imaging domains. Conclusion: Consensus was obtained for the determination of the monitorization interval and for most of the clinical variables. Most questions that did not reach consensus were related with the confirmation of progression taking into account only one test/domain, reinforcing the multifactorial nature of multiple sclerosis. |
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Consensus for the Early Identification of Secondary Progressive Multiple Sclerosis in Portugal: a Delphi PanelConsenso Português para a Identificação Precoce de Esclerose Múltipla Secundária Progressiva: Painel DelphiCHLC NEUHumansDisease ProgressionBiomarkersMultiple Sclerosis*PortugalMultiple Sclerosis, Chronic Progressive* / diagnosisIntroduction: Multiple sclerosis is a disease with a heterogeneous evolution. The early identification of secondary progressive multiple sclerosis is a clinical challenge, which would benefit from the definition of biomarkers and diagnostic tools applicable in the transition phase from relapsing-remitting multiple sclerosis to secondary progressive multiple sclerosis. We aimed to reach a Portuguese national consensus on the monitoring of patients with multiple sclerosis and on the more relevant clinical variables for the early identification of its progression. Material and methods: A Delphi panel which included eleven Portuguese Neurologists participated in two rounds of questions between July and August of 2021. In the first round, 39 questions which belonged to the functional, cognitive, imaging, biomarkers and additional evaluations were included. Questions for which no consensus was obtained in the first round (less than 80% of agreement), were appraised by the panel during the second round. Results: The response rate was 100% in both rounds and consensus was reached for a total of 33 questions (84.6%). Consensus was reached for monitoring time, evaluation scales and clinical variables such as the degree of brain atrophy and mobility reduction, changes suggestive of secondary progressive multiple sclerosis. Additionally, digital devices were considered tools with potential to identify disease progression. Most questions for which no consensus was obtained referred to the cognitive assessment and the remaining referred to both functional and imaging domains. Conclusion: Consensus was obtained for the determination of the monitorization interval and for most of the clinical variables. Most questions that did not reach consensus were related with the confirmation of progression taking into account only one test/domain, reinforcing the multifactorial nature of multiple sclerosis.Introdução: A esclerose múltipla é uma doença de evolução heterogénea. A identificação precoce da forma secundária progressiva é um desafio clínico, carecendo da definição de biomarcadores e ferramentas de diagnóstico aplicáveis na fase de transição da forma surto-remissão para a forma secundária progressiva. Este trabalho teve como objetivo estabelecer um consenso nacional português sobre a monitorização dos doentes e das variáveis clínicas mais relevantes para a identificação precoce da progressão da esclerose múltipla. Material e Métodos: Um painel Delphi constituído por 11 neurologistas portugueses respondeu a duas rondas de perguntas entre julho e agosto de 2021. Na primeira ronda foram incluídas 39 questões relacionadas com a avaliação funcional, cognitiva, imagiológica, de biomarcadores e outras, e na segunda, as questões para as quais não foi atingido consenso (menos de 80% de concordância) na primeira ronda voltaram a ser submetidas a avaliação pelo painel. Resultados: A taxa de resposta foi de 100% em ambas as rondas e 33 das 39 questões (84,6%) atingiram concordância. Foi atingido consenso relativamente ao tempo de monitorização dos doentes, às escalas de avaliação a empregar e a variáveis clínicas tais como o grau de atrofia cerebral ou redução da mobilidade, cuja alteração é sugestiva de esclerose múltipla secundária progressiva. Adicionalmente, os dispositivos digitais foram considerados ferramentas com potencial para identificar a progressão da doença. A maioria das questões para as quais não foi obtido consenso dizem respeito à avaliação cognitiva, estando as restantes inseridas nos domínios funcional e imagiológico. Conclusão: Foi obtido consenso para a determinação do intervalo de monitorização e para a maioria das variáveis clínicas. A maioria das questões sem consenso estavam relacionadas com a confirmação do diagnóstico de progressão tendo em conta apenas um teste/domínio, realçando a natureza multifatorial da esclerose múltipla.Ordem dos MédicosRepositório do Centro Hospitalar Universitário de Lisboa Central, EPESá, MJBasílio, CCapela, CCerqueira, JJMendes, IMorganho, ACorreia de Sá, JSalgado, VMartins Silva, AVale, JSousa, L2023-05-23T14:58:15Z20232023-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.17/4527engActa Med Port . 2023;36(3):167-173.10.20344/amp.18543info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-05-28T05:20:06Zoai:repositorio.chlc.min-saude.pt:10400.17/4527Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T17:56:32.913279Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Consensus for the Early Identification of Secondary Progressive Multiple Sclerosis in Portugal: a Delphi Panel Consenso Português para a Identificação Precoce de Esclerose Múltipla Secundária Progressiva: Painel Delphi |
title |
Consensus for the Early Identification of Secondary Progressive Multiple Sclerosis in Portugal: a Delphi Panel |
spellingShingle |
Consensus for the Early Identification of Secondary Progressive Multiple Sclerosis in Portugal: a Delphi Panel Sá, MJ CHLC NEU Humans Disease Progression Biomarkers Multiple Sclerosis* Portugal Multiple Sclerosis, Chronic Progressive* / diagnosis |
title_short |
Consensus for the Early Identification of Secondary Progressive Multiple Sclerosis in Portugal: a Delphi Panel |
title_full |
Consensus for the Early Identification of Secondary Progressive Multiple Sclerosis in Portugal: a Delphi Panel |
title_fullStr |
Consensus for the Early Identification of Secondary Progressive Multiple Sclerosis in Portugal: a Delphi Panel |
title_full_unstemmed |
Consensus for the Early Identification of Secondary Progressive Multiple Sclerosis in Portugal: a Delphi Panel |
title_sort |
Consensus for the Early Identification of Secondary Progressive Multiple Sclerosis in Portugal: a Delphi Panel |
author |
Sá, MJ |
author_facet |
Sá, MJ Basílio, C Capela, C Cerqueira, JJ Mendes, I Morganho, A Correia de Sá, J Salgado, V Martins Silva, A Vale, J Sousa, L |
author_role |
author |
author2 |
Basílio, C Capela, C Cerqueira, JJ Mendes, I Morganho, A Correia de Sá, J Salgado, V Martins Silva, A Vale, J Sousa, L |
author2_role |
author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Repositório do Centro Hospitalar Universitário de Lisboa Central, EPE |
dc.contributor.author.fl_str_mv |
Sá, MJ Basílio, C Capela, C Cerqueira, JJ Mendes, I Morganho, A Correia de Sá, J Salgado, V Martins Silva, A Vale, J Sousa, L |
dc.subject.por.fl_str_mv |
CHLC NEU Humans Disease Progression Biomarkers Multiple Sclerosis* Portugal Multiple Sclerosis, Chronic Progressive* / diagnosis |
topic |
CHLC NEU Humans Disease Progression Biomarkers Multiple Sclerosis* Portugal Multiple Sclerosis, Chronic Progressive* / diagnosis |
description |
Introduction: Multiple sclerosis is a disease with a heterogeneous evolution. The early identification of secondary progressive multiple sclerosis is a clinical challenge, which would benefit from the definition of biomarkers and diagnostic tools applicable in the transition phase from relapsing-remitting multiple sclerosis to secondary progressive multiple sclerosis. We aimed to reach a Portuguese national consensus on the monitoring of patients with multiple sclerosis and on the more relevant clinical variables for the early identification of its progression. Material and methods: A Delphi panel which included eleven Portuguese Neurologists participated in two rounds of questions between July and August of 2021. In the first round, 39 questions which belonged to the functional, cognitive, imaging, biomarkers and additional evaluations were included. Questions for which no consensus was obtained in the first round (less than 80% of agreement), were appraised by the panel during the second round. Results: The response rate was 100% in both rounds and consensus was reached for a total of 33 questions (84.6%). Consensus was reached for monitoring time, evaluation scales and clinical variables such as the degree of brain atrophy and mobility reduction, changes suggestive of secondary progressive multiple sclerosis. Additionally, digital devices were considered tools with potential to identify disease progression. Most questions for which no consensus was obtained referred to the cognitive assessment and the remaining referred to both functional and imaging domains. Conclusion: Consensus was obtained for the determination of the monitorization interval and for most of the clinical variables. Most questions that did not reach consensus were related with the confirmation of progression taking into account only one test/domain, reinforcing the multifactorial nature of multiple sclerosis. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-05-23T14:58:15Z 2023 2023-01-01T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.17/4527 |
url |
http://hdl.handle.net/10400.17/4527 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Acta Med Port . 2023;36(3):167-173. 10.20344/amp.18543 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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Ordem dos Médicos |
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Ordem dos Médicos |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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