Prognostic factors for the course of functional status of patients with ALS: a systematic review

@article{Creemers2014PrognosticFF,
  title={Prognostic factors for the course of functional status of patients with ALS: a systematic review},
  author={Huub Creemers and Hepke F. Grupstra and Frans Nollet and Leonard H. van den Berg and Anita Beelen},
  journal={Journal of Neurology},
  year={2014},
  volume={262},
  pages={1407-1423}
}
The progressive course of amyotrophic lateral sclerosis (ALS) results in an ever-changing spectrum of the care needs of patients with ALS. Knowledge of prognostic factors for the functional course of ALS may enhance clinical prediction and improve the timing of appropriate interventions. Our objective was to systematically review the evidence regarding prognostic factors for the rate of functional decline of patients with ALS, assessed with versions of the ALS Functional Rating Scale (ALSFRS… 
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The authors' large, multicenter study demonstrated the role of some clinical and demographic factors on ALS survival, and showed some interesting differences between referral centers’ patients and the general ALS population.
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Results showed that age of onset had a significant influence on survival time and the progression of bulbar symptoms, but had no influence on upper limb function in sporadic ALS.
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To provide a reliable record, a public policy in which all research and clinical centers might assess the parameters discussed herein is suggested is suggested to provide a comprehensible database to facilitate multicentered collaboration, validation, and clinical translation.
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TLDR
The dimensionality and fluctuating predictors of ALS survival must be considered when developing predictive models for clinical trial development or in-clinic usage and is needed for population and personalized forecasting of survival.
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TLDR
There is a trade-off between the drive to recruit trial participants soon after symptom onset, and reduced reliability of the ALSFRS-derived progression rate at enrolment, indicating the need for objective markers of disease activity as an alternative to survival-based end-points.
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