Patient-reported outcomes (SymptoMScreen) in a Brazilian scenario: most affected symptoms and their correlations with conventional scales

Introduction: Multiple sclerosis (MS) is an autoimmune and polysymptomatic disease with a relevant need for recording and monitoring symptoms. In this scenario, the Patient-reported outcomes (PROs) are important to measure the impact of the disease and to monitor issues such as silent progression. The SymptoMScreen was developed in 2017 and is designed to evaluate the impact of MS symptoms, through 12 neurological domains. It is a quick user-friendly scale with high reproducibility, easy access, previous use in clinical trials and potential association with well-known scales.

Objectives: To describe the most common debilitating symptoms in MS patients by using SymptoMScreen and its correlations in a Brazilian setting.

Methods: This is an observational, cross-sectional study, in a MS Outpatient Clinic where this PRO is routinely applied. The median of the global SymptoMScreen score was calculated and correlated with: Expanded Disability Status Scale (EDSS),  Timed 25-Foot Walk (T25FW), Nine-Hole Peg Test (9HPT), Symbol Digit Modalities Test (SDMT), California Verbal Learning Test (CVLT), Brief Visuospatial Memory Test - Revised (BVMT-R),  Multiple Sclerosis Impact Scale (MSIS-29) and Modified Fatigue Impact Scale (MFIS).

Results: 123 MS patients were included (mean/SD age 38.3/10.5 years, 76.4% females; mean/SD disease duration 9.5/7.5 years; median baseline EDSS 2.0); The three most affected domains were fatigue, cognition and anxiety. Global SymptoMScreen was significantly associated with EDSS (r=0.561; p<0.001); T25FW (r=0.370, p<0.001), 9HPT (r=0.352, p=0.007); MSIS-29 (r=0.556, p<0.001) and MFIS (r=0.448, p<0.001). Concerning correlations with SDMT, CVLT and BVMT-T, only trends were observed.

Conclusion: SymptoMScreen is a high-quality valuable tool for documenting and addressing patient symptoms in clinical settings, and may support remote monitoring. The global score was significantly correlated with conventional scales in our study.