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. 2023 Jul 18;13:11584. doi: 10.1038/s41598-023-38415-z

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© The Author(s) 2023

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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A graphical depiction of the complex relationship between relapses ( $Y$ ) and worsening of disability ( $X$ ). The parameters $β_{\hat{Z} Y}^{(x)}$ and $β_{\hat{Q} X}^{(y)}$ are the indirect contribution (residual effects) of the WS-GPI and RS-GPI on relapse risk and risk of worsening of disability. All other parameters represent direct associations.