Prognosis of the individual course of disease - steps in developing a decision support tool for Multiple Sclerosis
Prognosis of the individual course of disease - steps in developing a decision support tool for Multiple Sclerosis
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DOI：
10.1186/1472-6947-7-11
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发表时间：
2007-05-08
影响因子：
3.5
通讯作者：
Heiderhoff, M.
中科院分区：
文献类型：
--
作者：
Daumer, M.;Neuhaus, A.;Heiderhoff, M.
背景：多发性硬化是一种病因不明的慢性疾病。其病程的变化使得很难或不可能准确地确定个体患者的预后。Sylvia Lawry多发性硬化症研究中心（SLCMSR）开发了一种“在线分析处理（OLAP）”工具，该工具利用现有的临床试验数据，并允许为个体患者建模这种慢性疾病的近期未来进程。对于给定的患者，SLCMSR数据库中最相似的患者通过集成到OLAP中的基于模型的匹配算法智能地选择。工具，使真实的时间，基于Web的统计分析。基础数据库（最后更新于2005年4月）包含来自对照临床试验的30个安慰剂组的1，059例患者。显示整个数据库和选择用于比较的部分的人口统计信息。提供统计比较的结果作为数据库中个体的扩展残疾状态量表（EDSS）的过程的显示，其具有随时间推移可能进展的区域，连同其平均复发率沿着。还显示了至EDSS持续进展时间和至需要持续辅助行走时间（EDSS 6）的Kaplan-Meier曲线。软件应用OLAP预计输入MS患者的过程中的基础上的基线值和已知的病程为类似的患者谁已经遵循了临床试验。结论：这种模拟可能是有用的医生，研究人员和其他专业人士谁的咨询患者的治疗方案。如果存在OLAP操作的类似数据集，则可以修改应用程序以研究其他慢性疾病的自然史。
Background: Multiple sclerosis is a chronic disease of uncertain aetiology. Variations in its disease course make it difficult to impossible to accurately determine the prognosis of individual patients. The Sylvia Lawry Centre for Multiple Sclerosis Research (SLCMSR) developed an "online analytical processing (OLAP)" tool that takes advantage of extant clinical trials data and allows one to model the near term future course of this chronic disease for an individual patient.Results: For a given patient the most similar patients of the SLCMSR database are intelligently selected by a model-based matching algorithm integrated into an OLAP-tool to enable real time, web-based statistical analyses. The underlying database (last update April 2005) contains 1,059 patients derived from 30 placebo arms of controlled clinical trials. Demographic information on the entire database and the portion selected for comparison are displayed. The result of the statistical comparison is provided as a display of the course of Expanded Disability Status Scale (EDSS) for individuals in the database with regions of probable progression over time, along with their mean relapse rate. Kaplan-Meier curves for time to sustained progression in the EDSS and time to requirement of constant assistance to walk (EDSS 6) are also displayed. The software-application OLAP anticipates the input MS patient's course on the basis of baseline values and the known course of disease for similar patients who have been followed in clinical trials.Conclusion: This simulation could be useful for physicians, researchers and other professionals who counsel patients on therapeutic options. The application can be modified for studying the natural history of other chronic diseases, if and when similar datasets on which the OLAP operates exist.