AUTHOR=Wei Siqian , Du Yi , Luo Meifeng , Song Ruitong 

TITLE=Development of a predictive model for predicting disability after optic neuritis: a secondary analysis of the Optic Neuritis Treatment Trial

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2024

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1326261

DOI=10.3389/fneur.2023.1326261

ISSN=1664-2295

ABSTRACT=Objective: The aim of this study was to develop a prediction model for predicting developing disabilities after optic neuritis.
Methods: The data for this research was obtained from the Optic Neuritis Treatment Trial (ONTT). The predictive model was built based on a Cox proportional hazards regression. Model performance was assessed using Harrell's C-index for discrimination, calibration plots for calibration, and stratification of patients into low-risk and high-risk groups for utility evaluation.
Results: A total of 416 patients participated. Among them, 101 patients (24.3%) experienced disability, which was defined as achieving or surpassing a score of 3 on the Expanded Disability Status Scale. The median follow-up duration was 15.5 years (interquartile range, 7.0 to 16.8). Two predictors in the final predictive model included the classification of multiple sclerosis at baseline and the condition of the optic disc in the affected eye at baseline. Upon incorporating these two factors into the model, the model's C-index stood at 0.71 (95% CI, 0.66-0.76, with an optimism of 0.005) with a favorable alignment with the calibration curve. By utilizing this model, the ONTT cohort can be categorized into 2 risk categories, each having distinct rates of disability development within a 15-year timeframe (high-risk group, 41% [95% CI, 31%-49%]; and low-risk group, 13% [95% CI, 8.4%-17%]; log-rank P < 0.001).
Conclusion: This predictive model has the potential to assist physicians in identifying individuals at a heightened risk of experiencing disability following optic neuritis, enabling timely intervention and treatment.