| To be assessed | Tool | Outcome | Action |
---|---|---|---|---|
Step 1 | Physical HRQoL Control self-efficacy | MQoL-54 MSSES | Predictive score | If score in lowest quartile (>50% discontinuation risk) → 2A & 2B |
Step 2A | Depression & anxiety Fatigue Bladder | HADS MFIS Actionable | Diagnostic scores | If score(s) abnormal → further diagnosis and therapy If MSSES score(s) low → therapy? |
Step 2B | Prognosis | 1) Clinical 2) MRI 3) CSF | Prognostic indicators | If prognosis unfavourable > consider 2ndline DMD |