Development of a brief clinician-reported outcome measure of multiple sclerosis signs and symptoms: The Clinician Rating of Multiple Sclerosis (CRoMS)

Abstract

ObjectiveNo available assessment tool offers a brief and psychometrically sound way for clinicians to quantify assessment of MS in a typical office visit. The objective of this study was to develop a brief clinician-reported outcome measure of MS signs and symptoms to standardize and quantify assessments that occur during a typical neurology office visit. MethodsA questionnaire, called the Clinician Rating of Multiple Sclerosis (CRoMS), was developed in the following steps: literature review; concept elicitation interviews (to generate questionnaire themes and content) with patients with MS (n = 14); concept elicitation interviews with neurologists (n = 9); online qualitative survey with neurologists in the US, UK, Germany, and Sweden (n = 72); online survey with neurologists to evaluate the first draft of the clinician-reported outcome measure (ClinRO) (n = 26); an in-person meeting with neurologists to discuss and revise the draft ClinRO (n = 9); and interviews with neurologists and MS nurses to further refine and finalize the ClinRO (n = 16). ResultsAcross all steps of this research, several signs and symptoms consistently emerged as important for assessment in a typical office visit: walking, balance, upper limb function, coordination, weakness, fatigue, pain, sensory symptoms, bladder function, visual function, cognition, spasticity, spasms, and mood. The importance of these signs and symptoms was supported by neurologists during the online surveys and the in-person meeting. Neurologists were generally able to complete the draft ClinRO measure without difficulty, although minor revisions were suggested to refine the ClinRO for future use. ConclusionThe CRoMS may be a useful tool for efficiently assessing the severity of MS symptoms. This brief clinician-reported measure could help standardize and quantify assessments in clinical studies and clinical settings.