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Article History

Received: 8 May 2025

Revised: 25 July 2025

Accepted: 4 August 2025

First Online: 15 August 2025

Declarations

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: The authors declare the following competing interests: Author RHBB received honoraria, speaking, or consulting fees from Biogen, BMS, Celgene, EMD Serono, Merck, Novartis, Roche, and Sanofi and has received research support from Biogen, BMS, Genzyme, NIH, NMSS, and Novartis. He has also received royalties from Psychological Assessment Resources, Inc. Author BWG served as a consultant for Biogen, EMD Serono, Novartis, Genentech, Celgene/Bristol Meyers Squibb, Sanofi Genzyme, Bayer, Janssen, Labcorp, and Horizon. She served in the speaker bureau for Biogen. She has also received grant/research support from the agencies listed in the previous sentence. She serves on the editorial board for BMJ Neurology, Children, CNS Drugs, MS International, and Frontiers Epidemiology. All other authors declare no financial or non-financial competing interests.

: The dataset generated and analyzed during the current study is not publicly available but may be made available upon reasonable request and approval by the University at Buffalo institutional review board. The underlying code for this study is not publicly available for proprietary reasons.