{"doi":"10.1016/j.msard.2024.105755","title":"Clinical risk stratification: Development and validation of the DAAE score, a tool for estimating patient risk of transition to secondary progressive multiple sclerosis","abstract":"BACKGROUND: Because secondary progressive multiple sclerosis (SPMS) is associated with worse prognosis, early predictive tools are needed. We aimed to use systematic literature review and advanced methods to create and validate a clinical tool for estimating individual patient risk of transition to SPMS over five years. METHODS: Data from the Jacobs Multiple Sclerosis Center (JMSC) and the Multiple Sclerosis Center Amsterdam (MSCA) was collected between 1994 and 2022. Participants were relapsing-remitting adult patients at initial evaluation. We created the tool in four stages: (1) identification of candidate predictors from systematic literature review, (2) ordinal cutoff determination, (3) feature selection, (4) feature weighting. RESULTS: Patients in the development/internal-validation/external-validation datasets respectively (n = 787/n = 522/n = 877) had a median age of 44.1/42.4/36.6 and disease duration of 7.7/6.2/4.4 years. From these, 12.6 %/10.2 %/15.4 % converted to SPMS (median=4.9/5.2/5.0 years). The DAAE Score was named from included predictors: Disease duration, Age at disease onset, Age, EDSS. It ranges from 0 to 12 points, with risk groups of very-low=0-2, low=3-7, medium=8-9, and high≥10. Risk of transition to SPMS increased proportionally across these groups in development (2.7 %/7.4 %/18.8 %/40.2 %), internal-validation (2.9 %/6.8 %/26.8 %/36.5 %), and external-validation (7.5 %/9.6 %/22.4 %/37.5 %). CONCLUSION: The DAAE Score estimates individual patient risk of transition to SPMS consistently across datasets internationally using clinically-accessible data. With further validation, this tool could be used for clinical risk estimation.","journal":"Multiple Sclerosis and Related Disorders","year":2024,"id":448885,"datarank":0.281038401706624,"base_score":1.791759469228055,"endowment":1.791759469228055,"self_citation_contribution":0.26876392038420827,"citation_network_contribution":0.012274481322415697,"self_endowment_contribution":0.26876392038420827,"citer_contribution":0.012274481322415697,"corpus_percentile":43.22735360099018,"corpus_rank":7340,"citation_count":5,"citer_count":1,"citers_with_citation_signal":1,"citers_with_endowment":1,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.7051,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":350683,"name":"Robert Zivadinov","orcid":"0000-0002-7799-1485","position":1,"is_corresponding":false},{"id":1268249,"name":"Tetyana Pryshchepova","orcid":null,"position":2,"is_corresponding":false},{"id":289239,"name":"Bianca Weinstock‐Guttman","orcid":"0000-0001-6732-151X","position":3,"is_corresponding":false},{"id":350682,"name":"Michael G. Dwyer","orcid":"0000-0003-4684-4658","position":4,"is_corresponding":false},{"id":397563,"name":"Ralph H. B. Benedict","orcid":"0000-0002-2080-3631","position":5,"is_corresponding":false},{"id":397556,"name":"Niels Bergsland","orcid":"0000-0002-7792-0433","position":6,"is_corresponding":false},{"id":350680,"name":"Dejan Jakimovski","orcid":"0000-0001-7114-4958","position":7,"is_corresponding":false},{"id":873998,"name":"Tomáš Uher","orcid":"0000-0003-3160-9022","position":8,"is_corresponding":false},{"id":1268250,"name":"Julia R. Jelgerhuis","orcid":null,"position":9,"is_corresponding":false},{"id":242544,"name":"Frederik Barkhof","orcid":"0000-0003-3543-3706","position":10,"is_corresponding":false},{"id":624037,"name":"Bernard M.J. Uitdehaag","orcid":"0000-0002-9226-7364","position":11,"is_corresponding":false},{"id":279321,"name":"Joep Killestein","orcid":"0000-0002-6347-5957","position":12,"is_corresponding":false},{"id":1080946,"name":"Eva Strijbis","orcid":"0000-0001-6705-5864","position":13,"is_corresponding":false},{"id":931876,"name":"Menno M. Schoonheim","orcid":"0000-0002-2504-6959","position":14,"is_corresponding":false},{"id":706349,"name":"Tom Fuchs","orcid":"0000-0002-0219-3518","position":0,"is_corresponding":true}],"reference_count":38,"raw_metadata":null,"created_at":"2026-07-19T02:02:12.215092Z","pmid":"39018643","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}