New Tool May Pinpoint Individual ALS Prognosis
Clinicians may soon have a tool that provides more accurate prognoses for individuals diagnosed with amyotrophic lateral sclerosis (ALS). The prediction model incorporates eight factors significantly associated with a composite endpoint of noninvasive ventilation for more than 23 hours per day, tracheostomy, or death. Improved timing of clinical interventions and stratifying of participants in future clinical trials are additional goals of the study, which included 11,475 patients with ALS across nine European countries. The goal is for "medical doctors to provide predictions of survival for individual patients with ALS at the day of diagnosis. Before the development of our model, estimates of survival were mainly based on survival times in groups of patients," study investigator Henk-Jan Westeneng, MD, from the Brain Centre Rudolf Magnus, University Medical Centre, Utrecht, the Netherlands, told Medscape Medical News.
@udipta There is no cure for ALS. Survival rates can vary widely from several months to a decade or longer. Finding no sufficiently powered prediction tool based on individual risk, lead author Westeneng and colleagues identified 16 clinical, cognitive, and genetic prognostic factors from individual reports in the literature. Data collection ran from 1992 to 2016 at 14 specialized ALS centers. Median follow-up was slightly longer than 8 years. The primary outcome was the time between ALS symptom onset and the composite endpoint. Next, they performed backward elimination in the largest dataset with 1936 patients to select the most appropriate factors for the prediction model. They validated each selection through a series of bootstrap analyses.