{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T12:47:15Z","timestamp":1792154835614,"version":"4.4.0"},"reference-count":34,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The use of generative artificial intelligence to create synthetic data is an emerging strategy to enhance real-world evidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To assess the validity of artificial intelligence-generated synthetic data in replicating data collected in the Italian Multiple Sclerosis and Related Disorders Register for the evaluation of progression independent of relapse activity risk under early intensive treatment and escalation treatment strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Artificial intelligence generative models were trained on a sub-cohort of 1666 Italian Multiple Sclerosis and Related Disorders Register patients to generate a synthetic dataset of 4878 patients. Synthetic vAlidation FramEwork, Clinical Synthetic Fidelity, and Nearest Neighbor Distance Ratio were applied. Comparisons between treatment strategies were conducted using both real and synthetic data, focusing on progression independent of relapse activity risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The synthetic data demonstrated fidelity and privacy preservation. Treatment-effect estimates for escalation treatment versus early intensive treatment were similar across the real and synthetic datasets. Cox proportional hazards models showed that synthetic data preserved the robustness of the estimates for the risk of a first progression independent of relapse activity event. Associations with radiological risk factors were broadly similar across the real and synthetic datasets.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Artificial intelligence-generated synthetic data reliably replicated treatment-effect outcomes of Italian Multiple Sclerosis and Related Disorders Register data, supporting their potential use in clinically defined research settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585261492525","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T14:47:37Z","timestamp":1791989257000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Validation of generative artificial intelligence techniques for synthetic data generation in multiple sclerosis research: A comparison with real-world evidence from the Italian multiple sclerosis registry"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2308-1731","authenticated-orcid":false,"given":"Pietro","family":"Iaffaldano","sequence":"first","affiliation":[{"name":"Department of Translational Biomedicine and Neurosciences (DiBraiN), Multiple Sclerosis Center, Policlinico of Bari, University of Bari Aldo Moro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saverio","family":"D\u2019Amico","sequence":"additional","affiliation":[{"name":"IRCCS Humanitas Research Hospital, Milan, Italy"},{"name":"Train S.r.l., Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Lucisano","sequence":"additional","affiliation":[{"name":"Department of Translational Biomedicine and Neurosciences (DiBraiN), Multiple Sclerosis Center, Policlinico of Bari, University of Bari Aldo Moro, Italy"},{"name":"Center for Outcomes Research and Clinical Epidemiology\u2013CORESEARCH SRL, Pescara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7960-5947","authenticated-orcid":false,"given":"Massimiliano","family":"Copetti","sequence":"additional","affiliation":[{"name":"Unit of Biostatistics, Fondazione IRCCS \u201cCasa Sollievo della Sofferenza\u201d, San Giovanni Rotondo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5248-5981","authenticated-orcid":false,"given":"Tommaso","family":"Guerra","sequence":"additional","affiliation":[{"name":"Department of Translational Biomedicine and Neurosciences (DiBraiN), Multiple Sclerosis Center, Policlinico of Bari, University of Bari Aldo Moro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2358-4320","authenticated-orcid":false,"given":"Maria A.","family":"Rocca","sequence":"additional","affiliation":[{"name":"Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy"},{"name":"Vita-Salute San Raffaele University, Milan, Italy"},{"name":"Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Patti","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Mediche e Chirurgiche e Tecnologie Avanzate, GF Ingrassia, University of Catania, Italy"},{"name":"UOS Sclerosi Multipla, AOU Policlinico \u201cG Rodolico-San Marco\u201d, Universit\u00e0 di Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"De Luca","sequence":"additional","affiliation":[{"name":"Centro Sclerosi Multipla, Clinica Neurologica, Policlinico SS Annunziata, Universit\u00e0 \u201cG. d\u2019Annunzio\u201d, Chieti-Pescara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4818-3806","authenticated-orcid":false,"given":"Diana","family":"Ferraro","sequence":"additional","affiliation":[{"name":"Dipartimento di Neuroscienze, Ospedale Civile di Baggiovara, Azienda Ospedaliera-Universit\u00e0 di Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocco","family":"Totaro","sequence":"additional","affiliation":[{"name":"Centro Malattie Demielinizzanti, Ospedale San Salvatore, L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo Brescia","family":"Morra","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Reproductive and Odontostomatological Sciences, Multiple Sclerosis Clinical Care and Research Center, University of Naples Federico II, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Salemi","sequence":"additional","affiliation":[{"name":"Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9662-1762","authenticated-orcid":false,"given":"Emilio","family":"Portaccio","sequence":"additional","affiliation":[{"name":"Department of NEUROFARBA, University of Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Foschi","sequence":"additional","affiliation":[{"name":"Neurology Unit, Department of Neuroscience, Multiple Sclerosis Center, Santa Maria delle Croci Hospital, Azienda USL Romagna, Ravenna, Italy"},{"name":"Department of Biotechnological and Applied Clinical Sciences, University of L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matilde","family":"Inglese","sequence":"additional","affiliation":[{"name":"Dipartimento Di Neuroscienze, Riabilitazione, Oftalmologia, Genetica E Scienze Materno\u2013Infantili (DINOGMI), Universit\u00e0 di Genova, Italy"},{"name":"IRCCS, Ospedale Policlinico San Martino, Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria G.","family":"Coniglio","sequence":"additional","affiliation":[{"name":"Center for Multiple Sclerosis, ASM P.O. \u201cMadonna Delle Grazie\u201d, Matera, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara G.","family":"Chisari","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Mediche e Chirurgiche e Tecnologie Avanzate, GF Ingrassia, University of Catania, Italy"},{"name":"UOS Sclerosi Multipla, AOU Policlinico \u201cG Rodolico-San Marco\u201d, Universit\u00e0 di Catania, 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