Fig. 1

MS TreatSim workflow. In the first step, the user sets up the simulation by selecting population characteristics and inclusion/exclusion selection criteria (see also Fig. 2). Next, the user defines the trial groups and treatment strategies to be simulated and compared. Finally, the user defines the trial timelines including its duration and any additional intermediate analysis milestones of the trial. MS TreatSim’s simulation framework next generates DPs based on the defined population and includes them into the digital patient groups. Finally, each DP is simulated individually according to the group’s treatment of choice. The outputs generated by MS TreatSim are built on the individual simulations of each DP and are displayed in terms of clinical endpoints descriptive statistics, individual profiles, bubble and Kaplan–Meier plots