title: Early prediction of the long term evolution of multiple sclerosis: the Bayesian Risk Estimate for Multiple Sclerosis (BREMS) score.
abstract: OBJECTIVE
  To propose a simple tool for early prediction of unfavourable long term evolution of multiple sclerosis (MS).
  
  
  METHODS
  A Bayesian model allowed us to calculate, within the first year of disease and for each patient, the Bayesian Risk Estimate for MS (BREMS) score that represents the risk of reaching secondary progression (SP).
  
  
  RESULTS
  The median BREMS scores were higher in 158 patients who reached SP within 10 years compared with 1087 progression free patients (0.69 vs 0.30; p<0.0001). The BREMS value was related to SP risk in the whole cohort (p<0.0001) and in the subgroup of 535 patients who had never been treated with immune therapies, thus reasonably representing the natural history of the disease (p<0.000001).
  
  
  CONCLUSIONS
  The BREMS score may be useful both to identify patients who are candidates for early or for more aggressive therapies and to improve the design and analysis of clinical therapeutic trials and of observational studies.
authors.affiliation: Multiple Sclerosis Centre, Department of Clinical Neurology, Neurological Institute C Mondino, Via Mondino 2, 27100 Pavia, Italy. roberto.bergamaschi@mondino.it
authors.forename: Roberto
authors.initials: R
authors.lastname: Bergamaschi
authors.forename: Silvana
authors.initials: S
authors.lastname: Quaglini
authors.forename: Maria
authors.initials: M
authors.lastname: Trojano
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Amato
authors.forename: Eleonora
authors.initials: E
authors.lastname: Tavazzi
authors.forename: Damiano
authors.initials: D
authors.lastname: Paolicelli
authors.forename: Valentina
authors.initials: V
authors.lastname: Zipoli
authors.forename: Alfredo
authors.initials: A
authors.lastname: Romani
authors.forename: Aurora
authors.initials: A
authors.lastname: Fuiani
authors.forename: Emilio
authors.initials: E
authors.lastname: Portaccio
authors.forename: Carlo
authors.initials: C
authors.lastname: Berzuini
authors.forename: Cristina
authors.initials: C
authors.lastname: Montomoli
authors.forename: Stefano
authors.initials: S
authors.lastname: Bastianello
authors.forename: Vittorio
authors.initials: V
authors.lastname: Cosi
mesh_terms: D000328:Adult; D001499:Bayes Theorem; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D009103:Multiple Sclerosis / Q000473:pathology*; D011379:Prognosis; D012720:Severity of Illness Index