title: Physical and cognitive functioning after 3 years can be predicted using information from the diagnostic process in recently diagnosed multiple sclerosis.
abstract: OBJECTIVE
  To predict functioning after 3 years in patients with recently diagnosed multiple sclerosis (MS).
  
  
  METHODS
  Inception cohort with 3 years of follow-up. At baseline, predictors were obtained from medical history taking, neurologic examination, and magnetic resonance imaging (MRI).
  
  
  METHODS
  Neurology outpatient clinic.
  
  
  METHODS
  Patients with MS (N=156); 146 with complete follow-up.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Inability to walk at least 500 m, impaired dexterity, cognitive impairments, incontinence, inability to drive a car or use public transportation, social dysfunction, and reliance on a disability pension.
  
  
  RESULTS
  Clinical prediction rules were constructed for the models that were well calibrated (sufficient agreement between predicted and observed outcomes, based on visual inspection of calibration curves) and that showed sufficient discrimination (area under the receiver operation characteristic curve >.70) after internal bootstrap validation. The models for the inability to walk at least 500 m, impaired dexterity, and cognitive impairments were well calibrated. Discrimination was sufficient for all 7 models, except the one predicting social dysfunction (.67). The inability to walk at least 500 m was predicted by the perceived ability to walk, impairment of the cerebellar tract, and the number of MRI lesions in the spinal cord. Impaired dexterity was predicted by the perceived ability to use the hands, impairments of the pyramidal, cerebellar, and sensory tracts, and the T2-weighted infratentorial lesion load. Cognitive impairment was predicted by age, gender, the perceived ability to concentrate, and the T2-weighted supratentorial lesion load.
  
  
  CONCLUSIONS
  Inability to walk at least 500 m, impaired dexterity, and cognitive impairments can be predicted with predictors that are derived from medical history taking, neurologic examination, and MRI shortly after a definite diagnosis of MS has been made.
authors.affiliation: Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands. v.degroot@vumc.nl
authors.forename: Vincent
authors.initials: V
authors.lastname: de Groot
authors.forename: Heleen
authors.initials: H
authors.lastname: Beckerman
authors.forename: Bernard M
authors.initials: BM
authors.lastname: Uitdehaag
authors.forename: Rogier Q
authors.initials: RQ
authors.lastname: Hintzen
authors.forename: Arjan
authors.initials: A
authors.lastname: Minneboo
authors.forename: Martijn W
authors.initials: MW
authors.lastname: Heymans
authors.forename: Gustaaf J
authors.initials: GJ
authors.lastname: Lankhorst
authors.forename: Chris H
authors.initials: CH
authors.lastname: Polman
authors.forename: Lex M
authors.initials: LM
authors.lastname: Bouter
mesh_terms: D000293:Adolescent; D000328:Adult; D003072:Cognition Disorders / Q000175:diagnosis / Q000503:physiopathology*; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000503:physiopathology*; D055815:Young Adult