scholarly journals The use and quality of reporting of propensity score methods in multiple sclerosis literature: A review

2020 ◽  
pp. 135245852097255
Author(s):  
Mohammad Ehsanul Karim ◽  
Fabio Pellegrini ◽  
Robert W Platt ◽  
Gabrielle Simoneau ◽  
Julie Rouette ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Propensity Score ◽  
Statistical Tests ◽  
Quality Of Reporting ◽  
Propensity Score Methods ◽  
The Past ◽  
Disease Modifying Therapies ◽  
Pubmed Database ◽  
Effectiveness Studies

Background: Propensity score (PS) analyses are increasingly used in multiple sclerosis (MS) research, largely owing to the greater availability of large observational cohorts and registry databases. Objective: To evaluate the use and quality of reporting of PS methods in the recent MS literature. Methods: We searched the PubMed database for articles published between January 2013 and July 2019. We restricted the search to comparative effectiveness studies of two disease-modifying therapies. Results: Thirty-nine studies were included in the review, with most studies (62%) published within the past 3 years. All studies reported the list of covariates used for the PS model, but only 21% of studies mentioned how those covariates were selected. Most studies used PS matching (72%), followed by PS adjustment (18%), weighting (15%), and stratification (3%), with some overlap. Most studies using matching or weighting reported checking post-PS covariate imbalance (91%), although about 45% of these studies relied on p values from various statistical tests. Only 25% of studies using matching reported calculating robust standard errors for the PS analyses. Conclusions: The quality of reporting of PS methods in the MS literature is sub-optimal in general, and in some cases, inappropriate methods are used.

scholarly journals Anorectal Dysfunction in Multiple Sclerosis: A Systematic Review

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Sanober Nusrat ◽  
Elsie Gulick ◽  
David Levinthal ◽  
Klaus Bielefeldt
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Fecal Incontinence ◽  
English Language ◽  
Controlled Trial ◽  
Neuromuscular Diseases ◽  
Anorectal Dysfunction ◽  
Pubmed Database ◽  
Marginal Improvement

Constipation and fecal incontinence are common in patients with neuromuscular diseases. Despite their high prevalence and potential impact on overall quality of life, few studies have addressed anorectal dysfunction in patients with multiple sclerosis (MS). The goal of this paper is to define the prevalence, pathophysiology, impact, and potential treatment of constipation and incontinence in MS patients. Methods. The PubMed database was searched for English language publications between January 1973 and December 2011. Articles were reviewed to assess the definition of the study population, duration, type and severity of MS, sex distribution, prevalence, impact, results of physiologic testing, and treatments. Results. The reported prevalence of constipation and fecal incontinence ranged around 40%. Anorectal dysfunction significantly affected patients with nearly 1 in 6 patients limiting social activities or even quitting work due to symptoms. Caregivers listed toileting as a common and significant burden. The only randomized controlled trial showed a marginal improvement of constipation with abdominal massage. All other reports lacked control interventions and only demonstrated improvement in individuals with milder symptoms. Conclusion. Anorectal dysfunction is a common manifestation in MS that significantly affects quality of life. Therapies are at best moderately effective and often cumbersome, highlighting the need for simple and more helpful interventions.

Improved quality of reporting safety data of medication in paediatric randomised controlled trials

2021 ◽  
pp. archdischild-2020-321197
Author(s):  
Taco Jan Prins ◽  
Corine Rollema ◽  
Eric van Roon ◽  
Tjalling de Vries
Keyword(s):  
Adverse Events ◽  
Randomised Controlled Trials ◽  
Safety Data ◽  
Drug Event ◽  
Controlled Trials ◽  
Quality Of Reporting ◽  
Event Reporting ◽  
The Past ◽  
Randomised Controlled

ObjectiveEvaluating the reporting of safety data of medication in paediatric randomised controlled trials (RCTs) in 2017–2018 compared with our earlier study.DesignLiterature search with a systemic appraisal of adverse drug event reporting.Main outcome measuresQuality of reporting of safety data using Consolidated Standards of Reporting Trials (CONSORT) and Ioannidis scores in paediatric drug RCTs. The CONSORT score consists of nine recommendations of the CONSORT Group issued to improve the quality of reporting adverse events. The Ioannidis score is based on these advices. We considered a CONSORT score of at least 6 and an Ioannidis score of at least 3 as sufficient.ResultsWe reviewed 100 RCTs published in 2017 and 2018. Ninety-four (94%) articles mentioned adverse events compared with 78% in the earlier study. Fifty-seven per cent used a standardised method for reporting adverse events compared with 34% in our earlier study. In 26 of the articles, the expected adverse events were defined, and 27 articles had a preset standardised scale for adverse events. Of these, 62 articles (62%) had a CONSORT score of 6 or higher compared with 18% in 2010. In the present study, 67% had an Ioannidis score of 3 or higher, whereas in the earlier study this was 29%. Both differences are statistically significant (p<0.05).ConclusionsReporting safety data in paediatric RCTs has improved over the past 10 years. However, there is still room for improvement and for further improvement. Authors and editors should give more attention to methods for collecting, reporting and presenting safety data of RCTs in studies and manuscripts.

scholarly journals Monoclonal Antibodies in Multiple Sclerosis: Present and Future

Biomedicines ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 20 ◽  
Author(s):  
Natalia Voge ◽  
Enrique Alvarez
Keyword(s):  
Multiple Sclerosis ◽  
Monoclonal Antibodies ◽  
Morbidity Rate ◽  
High Morbidity ◽  
Disease Modifying Therapies ◽  
High Morbidity Rate ◽  
New Treatments ◽  
Near Future ◽  
Risk Ratios

The global incidence of multiple sclerosis (MS) appears to be increasing. Although it may not be associated with a high mortality rate, this disease has a high morbidity rate which affects the quality of life of patients and reduces their ability to do their activities of daily living. Thankfully, the development of novel disease modifying therapies continues to increase. Monoclonal antibodies (MABs) have become a mainstay of MS treatment and they are likely to continue to be developed for the treatment of this disease. Specifically, MABs have proven to be some of the most efficacious treatments at reducing relapses and the inflammation in MS patients, including the first treatment for primary progressive MS and are being explored as reparative/remyelinating agents as well. These relatively new treatments will be reviewed here to help evaluate their efficacy, adverse events, immunogenicity, and benefit-risk ratios in the treatment of the diverse spectrum of MS. The focus will be on MABs that are currently approved or may be approved in the near future.

scholarly journals Future of Management of Multiple Sclerosis in the Middle East: A Consensus View from Specialists in Ten Countries

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Mohammed Aljumah ◽  
Raed Alroughani ◽  
I. Alsharoqi ◽  
Saeed A. Bohlega ◽  
Maurice Dahdaleh ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Middle East ◽  
Middle Eastern ◽  
Regulatory Body ◽  
Optimal Care ◽  
Single Vision ◽  
Disease Modifying Therapies ◽  
The Future ◽  
Risk Ratios

The prevalence of multiple sclerosis (MS) is now considered to be medium-to-high in the Middle East and is rising, particularly among women. While the characteristics of the disease and the response of patients to disease-modifying therapies are generally comparable between the Middle East and other areas, significant barriers to achieving optimal care for MS exist in these developing nations. A group of physicians involved in the management of MS in ten Middle Eastern countries met to consider the future of MS care in the region, using a structured process to reach a consensus. Six key priorities were identified: early diagnosis and management of MS, the provision of multidisciplinary MS centres, patient engagement and better communication with stakeholders, regulatory body education and reimbursement, a commitment to research, and more therapy options with better benefit-to-risk ratios. The experts distilled these priorities into a single vision statement: “Optimization of patient-centred multidisciplinary strategies to improve the quality of life of people with MS.” These core principles will contribute to the development of a broader consensus on the future of care for MS in the Middle East.

scholarly journals Brief Course of Ultra-High Dose IV Methylprednisolone in the Treatment of Multiple Sclerosis Exacerbations

2020 ◽  
pp. 1-4
Author(s):  
Robert Knobler ◽  
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
High Dose ◽  
Side Effect Profile ◽  
Intravenous Methylprednisolone ◽  
The Past ◽  
Disease Modifying Therapies ◽  
Cord Injury ◽  
Disease Modifying

Despite the introduction of a number of effective disease modifying therapies (DMT) for multiple sclerosis (MS) over the past 25 years, a need remains for an effective method of treating breakthrough relapses, which impact disease progression. ACTH and corticosteroids have fulfilled this role for the past 50 years. However, based upon our current understanding of the cadence of an exacerbation, and its importance in the progression of MS, an alternative is proposed. This utilizes a very brief course of an ultra-high dose of intravenous methylprednisolone, adapted from the megadose protocol of methylprednisolone in acute spinal cord injury. Despite the known side effect profile of corticosteroids, and the ultra-high dose employed, the brevity in administration yields a well-tolerated, rapid resolution of the relapse

scholarly journals Access to and Use of Clinical Services and Disease-Modifying Therapies by People with Progressive Multiple Sclerosis in the United Kingdom

2017 ◽  
Vol 19 (6) ◽  
pp. 275-282 ◽  
Author(s):  
Evan Campbell ◽  
Elaine H. Coulter ◽  
Paul Mattison ◽  
Angus McFadyen ◽  
Linda Miller ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Progressive Multiple Sclerosis ◽  
Clinical Services ◽  
The United Kingdom ◽  
Disease Modifying Therapies ◽  
Disease Modifying ◽  
The Uk ◽  
Regular Review

Background: According to current UK guidelines, everyone with progressive multiple sclerosis (MS) should have access to an MS specialist, but levels of access and use of clinical services is unknown. We sought to investigate access to MS specialists and use of clinical services and disease-modifying therapies (DMTs) by people with progressive MS in the United Kingdom. Methods: A UK-wide online survey was conducted via the UK MS Register. The inclusion criteria were age 18 years or older, primary or secondary progressive MS, and a member of the UK MS Register. Participants were asked about access to MS specialists, recent clinical service use, receipt of regular review, and current and previous DMT use. Participant demographic data, quality of life, and disease impact measures were from the UK MS Register. Results: In total, 1298 individuals responded: 7% were currently taking a DMT, 23% had previously taken a DMT, and 95% reported access to an MS specialist. The most used practitioners were MS doctors/nurses (50%), general practitioners (45%), and physiotherapists (40%). Seventy-four percent of participants received a regular review, although 37% received theirs less often than annually. Current DMT use was associated with better quality of life, but past DMT use was associated with poorer quality of life and higher impact of disease. Conclusions: Access to and use of MS specialists was high. However, a gap in service provision was highlighted in both receipt and frequency of regular reviews.

Quality of Abstracts Describing Randomized Trials in the Proceedings of American Society of Clinical Oncology Meetings: Guidelines for Improved Reporting

2004 ◽  
Vol 22 (10) ◽  
pp. 1993-1999 ◽  
Author(s):  
Monika K. Krzyzanowska ◽  
Melania Pintilie ◽  
Christine Brezden-Masley ◽  
Rebecca Dent ◽  
Ian F. Tannock
Keyword(s):  
Clinical Oncology ◽  
Statistical Tests ◽  
Quality Score ◽  
Final Report ◽  
Quality Of Reporting ◽  
Randomized Controlled ◽  
End Point ◽  
American Society ◽  
Almost All

Purpose To evaluate the quality of reporting in abstracts describing randomized controlled trials (RCTs) included in the Proceedings of American Society of Clinical Oncology (ASCO) meetings and to propose reporting guidelines for abstracts that are submitted to future meetings. Methods Guidelines for reporting of RCTs in abstracts were developed by extracting key elements from published guidelines for full reports of RCTs, and modified based on an expert survey. Abstracts presenting results of RCTs with sample size ≥ 200 were identified from the ASCO Proceedings for the years 1989 to 1998. Information regarding the quality of each abstract was extracted, and a quality score (possible range, 0 to 10) was assigned based on adherence to the guidelines. Results Brief description of the intervention, explicit identification of the primary end point, and presentation of results accompanied by statistical tests were regarded by experts as the most important items to include in an abstract, whereas presentation of secondary and subgroup analyses was the least important. Deficiencies in reporting were present in almost all of the 510 abstracts; for example, only 22% of the abstracts provided explicit identification of the primary end point. The median quality score was 5.5 (range, 2.0 to 8.5); the quality score improved with time (P < .0001) and was better for oral or plenary presentations (P = .0003). Conclusion The quality of reporting of RCTs in abstracts submitted to Annual Meetings of ASCO is suboptimal. Although space precludes the inclusion of details required in the final report, abstracts could be improved through the use of explicit minimal guidelines, which are suggested in this article.

Causes of delayed management of multiple sclerosis patients in Nasr city health insurance hospital

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M M Wahib ◽  
M O Abdulghani ◽  
H M A Aref ◽  
A M A Nasef
Keyword(s):  
Multiple Sclerosis ◽  
Daily Activities ◽  
Disease Modifying Therapies ◽  
Relapsing Remitting ◽  
The Face ◽  
Muscle Spasms ◽  
Save Energy ◽  
Multiple Sclerosis Patients ◽  
Fair Degree

Abstract In multiple sclerosis (MS), the immune system attacks and destroys the fatty myelin coating that surrounds and insulates nerve cells in a process known as demyelination. MS is a lifelong condition, and common symptoms include fatigue, muscle spasms, walking difficulties, or numbness and tingling of the face, body, arms and legs. These symptoms can worsen with time, affecting daily activities and reducing a person’s quality of life. The disease is highly variable, and some people are affected more than others upon and after diagnosis. Treatments are available to help manage a number of symptoms. Life expectancy for people with MS has increased considerably in the last 20 to 25 years. On average, however, a person with MS can expect to live seven fewer years than someone without this disease. According to the National MS Society, on average, an MS patient lives about seven fewer years than someone in the general public, largely because of disease complications or other medical conditions, like cardiovascular disease. Only rarely does the disease progress so quickly that it is deadly. Due to advances in treatments, care, and lifestyle adjustments, MS often progresses slowly. Many studies show that, nowadays, about two-thirds of all patients retain a fair degree of mobility—the ability to walk, although likely with an assisted device—some 20 years after being diagnosed. Assisted devices can range from supports to aid in walking, to scooters used on occasion to save energy and avoid fatigue. The course of the disease depends on each patient’s risk factors, like having a family member with MS, cigarette smoking, and vitamin D sunlight exposure. And, among African-Americans, the disease tends to be a more progressive form and progression can be quicker. MS prognosis is thought to be better for people with relapsing-remitting MS than for those with progressive forms of MS, likely because of a better response to disease-modifying therapies.

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