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dc.contributor.authorKosa, Peter
dc.contributor.authorBarbour, Christopher
dc.contributor.authorWichman, Alison
dc.contributor.authorSandford, Mary
dc.contributor.authorGreenwood, Mark C.
dc.contributor.authorBielekova, Bibiana
dc.date.accessioned2019-02-06T19:16:43Z
dc.date.available2019-02-06T19:16:43Z
dc.date.issued2018-10
dc.identifier.citationKosa, Peter, Christopher Barbour, Alison Wichman, Mary Sandford, Mark Greenwood, and Bibiana Bielekova. "NeurEx: digitalized neurological examination offers a novel high-resolution disability scale." Annals of Clinical and Translational Neurology 5, no. 10 (October 2018): 1241-1249. DOI:10.1002/acn3.640.en_US
dc.identifier.issn2328-9503
dc.identifier.urihttps://scholarworks.montana.edu/xmlui/handle/1/15217
dc.description.abstractObjective To develop a sensitive neurological disability scale for broad utilization in clinical practice. Methods We employed advances of mobile computing to develop an iPad-based App for convenient documentation of the neurological examination into a secure, cloud-linked database. We included features present in four traditional neuroimmunological disability scales and codified their automatic computation. By combining spatial distribution of the neurological deficit with quantitative or semiquantitative rating of its severity we developed a new summary score (called NeurEx; ranging from 0 to 1349 with minimal measurable change of 0.25) and compared its performance with clinician- and App-computed traditional clinical scales. Results In the cross-sectional comparison of 906 neurological examinations, the variance between App-computed and clinician-scored disability scales was comparable to the variance between rating of the identical neurological examination by multiple sclerosis (MS)-trained clinicians. By eliminating rating ambiguity, App-computed scales achieved greater accuracy in measuring disability progression over time (n = 191 patients studied over 880.6 patient-years). The NeurEx score had no apparent ceiling effect and more than 200-fold higher sensitivity for detecting a measurable yearly disability progression (i.e., median progression slope of 8.13 relative to minimum detectable change of 0.25) than Expanded Disability Status Scale (EDSS) with a median yearly progression slope of 0.071 that is lower than the minimal measurable change on EDSS of 0.5. Interpretation NeurEx can be used as a highly sensitive outcome measure in neuroimmunology. The App can be easily modified for use in other areas of neurology and it can bridge private practice practitioners to academic centers in multicenter research studies.en_US
dc.language.isoenen_US
dc.rightsCC BY-NC-ND: This license is the most restrictive of our six main licenses, only allowing you to download this work and share it with others as long as you credit the original creator, but you can’t change the work in any way or use it commercially.en_US
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/legalcodeen_US
dc.titleNeurEx: digitalized neurological examination offers a novel high-resolution disability scaleen_US
dc.typeArticleen_US
mus.citation.extentfirstpage1241en_US
mus.citation.extentlastpage1249en_US
mus.citation.issue10en_US
mus.citation.journaltitleAnnals of Clinical and Translational Neurologyen_US
mus.citation.volume5en_US
mus.identifier.categoryHealth & Medical Sciencesen_US
mus.identifier.doi10.1002/acn3.640en_US
mus.relation.collegeCollege of Letters & Scienceen_US
mus.relation.departmentMathematical Sciences.en_US
mus.relation.universityMontana State University - Bozemanen_US
mus.data.thumbpage7en_US


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CC BY-NC-ND: This license is the most restrictive of our six main licenses, only allowing you to download this work and share it with others as long as you credit the original creator, but you can’t change the work in any way or use it commercially.
Except where otherwise noted, this item's license is described as CC BY-NC-ND: This license is the most restrictive of our six main licenses, only allowing you to download this work and share it with others as long as you credit the original creator, but you can’t change the work in any way or use it commercially.

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