mcdonald_ms_criteria: McDonald Criteria for Multiple Sclerosis (2017 Revision)

In cliot: Clinical Indices and Outcomes Tools

McDonald Criteria for Multiple Sclerosis (2017 Revision)

Description

Evaluates the 2017 Revised McDonald Criteria for the diagnosis of Multiple Sclerosis (MS). Diagnosis relies on demonstrating Dissemination in Space (DIS) and Dissemination in Time (DIT). A key update in the 2017 revision is that the presence of CSF-specific oligoclonal bands can substitute for the requirement of DIT in patients with a typical clinically isolated syndrome (CIS).

Usage

mcdonald_ms_criteria(clinical_attacks, clinical_lesions, dis_demonstrated,
                     dit_demonstrated, csf_oligoclonal_bands)

Arguments

clinical_attacks	Numeric. Number of clinical attacks (relapses). (1 or >=2).
clinical_lesions	Numeric. Number of lesions with objective clinical evidence. (1 or >=2).
dis_demonstrated	Numeric (0 or 1). Dissemination in Space (DIS) demonstrated by MRI (>=1 T2 lesion in >=2 MS-typical regions: periventricular, cortical/juxtacortical, infratentorial, spinal cord). (1 = Yes).
dit_demonstrated	Numeric (0 or 1). Dissemination in Time (DIT) demonstrated by MRI (simultaneous presence of gadolinium-enhancing and non-enhancing lesions, or a new T2/enhancing lesion on follow-up). (1 = Yes).
csf_oligoclonal_bands	Numeric (0 or 1). Presence of CSF-specific oligoclonal bands. (1 = Yes). Note: Can substitute for DIT in the 2017 criteria for CIS.

Value

A list containing:

Diagnosis	"Multiple Sclerosis (MS)" or "Possible MS / Clinically Isolated Syndrome (CIS)".
Missing_Requirements	List of criteria still needed to confirm the diagnosis.

References

Thompson AJ, Banwell BL, Barkhof F, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2018;17(2):162-173. doi:10.1016/S1474-4422(17)30470-2

Examples

# Example 1: 2 attacks, 1 clinical lesion, DIS on MRI
# Result: MS Diagnosed
mcdonald_ms_criteria(2, 1, 1, 0, 0)

# Example 2: CIS (1 attack, 1 lesion), DIS on MRI, No DIT on MRI, but CSF Positive
# Result: MS Diagnosed (CSF substitutes for DIT)
mcdonald_ms_criteria(1, 1, 1, 0, 1)

# Example 3: CIS (1 attack, 2 lesions), No DIT, No CSF
# Result: Possible MS (Missing DIT/CSF)
mcdonald_ms_criteria(1, 2, 0, 0, 0)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.