The natural history of multiple sclerosis: a geographically based study. 4. Applications to planning and interpretation of clinical therapeutic trials.

We used hypothetical entry criteria typical of those used in clinical therapeutic trials to determine the patients who would have been eligible among those followed in a clinic-based study of multiple sclerosis (MS) in London, Ontario, between 1972 and 1984. For these patients, we determined the obs...

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Main Authors: Weinshenker, BG, Rice, G, Noseworthy, J, Carriere, W, Baskerville, J, Ebers, G
Format: Journal article
Language:English
Published: 1991
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author Weinshenker, BG
Rice, G
Noseworthy, J
Carriere, W
Baskerville, J
Ebers, G
author_facet Weinshenker, BG
Rice, G
Noseworthy, J
Carriere, W
Baskerville, J
Ebers, G
author_sort Weinshenker, BG
collection OXFORD
description We used hypothetical entry criteria typical of those used in clinical therapeutic trials to determine the patients who would have been eligible among those followed in a clinic-based study of multiple sclerosis (MS) in London, Ontario, between 1972 and 1984. For these patients, we determined the observed frequency of deterioration by 1 point on the disability status scale (DSS) of Kurtzke, which is the most feasible and frequently used endpoint in clinical trials. We calculated the number of patients required for a randomized clinical trial to detect a significant result (alpha = 0.05) with 80% or 90% power based on the observed rate of deterioration. To assess the linearity of the DSS, we determined the frequency of progression and staying time at each level of the DSS. Overall the frequency of progression was lower and the staying times were longer at higher levels of disability. There was considerable intrapatient as well as interpatient variation in staying time. These data have major implications for the design and conduct of clinical therapeutic trials in MS.
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spelling oxford-uuid:e5e84a15-0fdb-4767-a8bb-97480e407fb52022-03-27T10:27:23ZThe natural history of multiple sclerosis: a geographically based study. 4. Applications to planning and interpretation of clinical therapeutic trials.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:e5e84a15-0fdb-4767-a8bb-97480e407fb5EnglishSymplectic Elements at Oxford1991Weinshenker, BGRice, GNoseworthy, JCarriere, WBaskerville, JEbers, GWe used hypothetical entry criteria typical of those used in clinical therapeutic trials to determine the patients who would have been eligible among those followed in a clinic-based study of multiple sclerosis (MS) in London, Ontario, between 1972 and 1984. For these patients, we determined the observed frequency of deterioration by 1 point on the disability status scale (DSS) of Kurtzke, which is the most feasible and frequently used endpoint in clinical trials. We calculated the number of patients required for a randomized clinical trial to detect a significant result (alpha = 0.05) with 80% or 90% power based on the observed rate of deterioration. To assess the linearity of the DSS, we determined the frequency of progression and staying time at each level of the DSS. Overall the frequency of progression was lower and the staying times were longer at higher levels of disability. There was considerable intrapatient as well as interpatient variation in staying time. These data have major implications for the design and conduct of clinical therapeutic trials in MS.
spellingShingle Weinshenker, BG
Rice, G
Noseworthy, J
Carriere, W
Baskerville, J
Ebers, G
The natural history of multiple sclerosis: a geographically based study. 4. Applications to planning and interpretation of clinical therapeutic trials.
title The natural history of multiple sclerosis: a geographically based study. 4. Applications to planning and interpretation of clinical therapeutic trials.
title_full The natural history of multiple sclerosis: a geographically based study. 4. Applications to planning and interpretation of clinical therapeutic trials.
title_fullStr The natural history of multiple sclerosis: a geographically based study. 4. Applications to planning and interpretation of clinical therapeutic trials.
title_full_unstemmed The natural history of multiple sclerosis: a geographically based study. 4. Applications to planning and interpretation of clinical therapeutic trials.
title_short The natural history of multiple sclerosis: a geographically based study. 4. Applications to planning and interpretation of clinical therapeutic trials.
title_sort natural history of multiple sclerosis a geographically based study 4 applications to planning and interpretation of clinical therapeutic trials
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