The Issue of Practice Effects on MS Performance Tests: Stephen Rao, PhD, ABPP-Cn


The Ralph and Luci Schey Chair and Director of the Schey Center for Cognitive Neuroimaging at Cleveland Clinic discussed his team’s investigations presented at the 2021 AAN Annual Meeting.

"[Practice effects] are a problem when it comes to interpretation of whether the person has gotten worse, because technically, they could have gotten worse, but their performance looks like it's flat, because the practice effects have negated the deterioration in performance.”

Significant practice effects (PE) exist with several facets of the multiple sclerosis performance test (MSPT) battery, according to a recent study presented at the 2021 American Academy of Neurology (AAN) Annual Meeting, April 17-22, by Shirley Liao, PhD, MS, biostatistician, Biogen.

Liao and colleagues found that Processing Speed Test scores (PST; average increase, 3 points; P <.001) and Manual Dexterity Test scores (MDT; average decrease, 1 second; P = .005) showed significant PE. Walking speed test (WST) scores did not show significant PE (P = .07). Larger PE was seen with younger patients (P <.001), patients with fewer self-reported depression symptoms (P <.001), and patients with lower baseline Patient Determined Disease Steps (P <.001) after Bonferroni correction.

NeurologyLive spoke with senior author Stephen Rao, PhD, ABPP-Cn, Ralph and Luci Schey Chair, and director, Schey Center for Cognitive Neuroimaging, Cleveland Clinic, to learn more about issue of practice effects in evaluating MS progression. He also discussed the MS PATHS database of patients used for the study.

For more coverage of AAN 2021, click here.

Liao S, de Moor C, Williams JR, Fisher E, Rao S. Real-world practice effects and effect modifiers of neuroperformance tests in Multiple Sclerosis Partners Advancing Technology and Health Solutions (MS PATHS). Presented at the 2021 American Academy of Neurology Annual Meeting; April 17-22 Abstract P15 037.
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