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Comparison of 2 Methods for Estimating Multiple Sclerosis-Related Mortality: The Excess Mortality vs the Cause-Specific Frameworks

dc.rights.licenseopenen_US
dc.contributor.authorROLLOT, F.
dc.contributor.authorUHRY, Z.
dc.contributor.authorDANTONY, E.
dc.contributor.authorVUKUSIC, S.
dc.contributor.authorDEBOUVERIE, M.
dc.contributor.authorLE PAGE, E.
dc.contributor.authorCIRON, J.
hal.structure.identifierNeurocentre Magendie : Physiopathologie de la Plasticité Neuronale [U1215 Inserm - UB]
dc.contributor.authorRUET, Aurelie
dc.contributor.authorDE SÈZE, J.
dc.contributor.authorZÉPHIR, H.
dc.contributor.authorLABAUGE, P.
dc.contributor.authorDEFER, G.
dc.contributor.authorLEBRUN-FRENAY, C.
dc.contributor.authorMOREAU, T.
dc.contributor.authorLAPLAUD, D.A.
dc.contributor.authorBERGER, E.
dc.contributor.authorCLAVELOU, P.
dc.contributor.authorPELLETIER, J.
dc.contributor.authorTHOUVENOT, E.
dc.contributor.authorHEINZLEF, O.
dc.contributor.authorCAMDESSANCHE, J.-P.
dc.contributor.authorFAUVERNIER, M.
dc.contributor.authorREMONTET, L.
dc.contributor.authorLERAY, E.
dc.date.accessioned2024-05-03T12:23:24Z
dc.date.available2024-05-03T12:23:24Z
dc.date.issued2023-12-12
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/199607
dc.description.abstractEnBackground and ObjectivesDetermining whether multiple sclerosis (MS) causes death is challenging. Our objective was to contrast 2 frameworks to estimate probabilities of death attributed to MS (PMS) and other causes (Pother): the cause-specific framework (CSF), which requires the causes of death, and the excess mortality framework (EMF), which does not.MethodsWe used data from the Observatoire Français de la Sclérose en Plaques (OFSEP, n = 37,524) and from a comparative subset where causes of death were available (4,004 women with relapsing-onset MS [R-MS]). In CSF, the probabilities were estimated using the Aalen-Johansen method. In EMF, they were estimated from the excess mortality hazard, which is the additional mortality among patients with MS as compared with the expected mortality in the matched general population. PMS values were estimated at 30 years of follow-up, (1) with both frameworks in the comparative subset, by age group at onset, and (2) with EMF only in the OFSEP population, by initial phenotype, sex, and age at onset.ResultsIn the comparative subset, the estimated 30-year PMS values were greater using EMF than CSF: 10.9% (95% CI 8.3-13.6) vs 8.7% (6.4-11.8) among the youngest and 20.4% (11.3-29.5) vs 16.2% (8.7-30.2) for the oldest groups, respectively. In the CSF, probabilities of death from unknown causes ranged from 1.5% (0.7-3.0) to 6.4% (2.5-16.4), and even after their reallocation, PMS values remained lower with CSF than with EMF. The estimated probabilities of being alive were close using the 2 frameworks, and the estimated POther (EMF vs CSF) was 2.6% (2.5-2.6) vs 2.1% (1.2-3.9) and 18.1% (16.9-19.3) vs 26.4% (16.5-42.2), respectively, for the youngest and oldest groups. In the OFSEP population, the estimated 30-year PMS values ranged from 7.5% (6.4-8.7) to 24.0% (19.1-28.9) in patients with R-MS and from 25.4% (21.1-29.7) to 36.8% (28.3-45.3) in primary progressive patients, depending on sex and age.DiscussionEMF has the great advantage of not requiring death certificates, their quality being less than optimal. Conceptually, it also seems more relevant because it avoids having to state, for each individual, whether death was directly or indirectly caused by MS or whether it would have occurred anyway, which is especially difficult in such chronic diseases. © American Academy of Neurology.
dc.language.isoENen_US
dc.subject.enFemale
dc.subject.enHumans
dc.subject.enMultiple Sclerosis* / epidemiology
dc.subject.enProbability
dc.title.enComparison of 2 Methods for Estimating Multiple Sclerosis-Related Mortality: The Excess Mortality vs the Cause-Specific Frameworks
dc.title.alternativeNeurologyen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1212/WNL.0000000000207925en_US
dc.subject.halSciences du Vivant [q-bio]/Neurosciences [q-bio.NC]en_US
dc.identifier.pubmed37827849en_US
bordeaux.journalNeurologyen_US
bordeaux.pageE2483-E2496en_US
bordeaux.volume101en_US
bordeaux.hal.laboratoriesNeurocentre Magendie - U1215en_US
bordeaux.issue24en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.teamRelations glie-neuroneen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.popularnonen_US
hal.audienceInternationaleen_US
hal.exportfalse
dc.rights.ccPas de Licence CCen_US
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