scholarly journals Handgun purchasing characteristics and firearm suicide risk: a nested case–control study

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Julia P. Schleimer ◽  
Rose M. C. Kagawa ◽  
Hannah S. Laqueur
Keyword(s):  
Suicide Risk ◽  
Conditional Logistic Regression ◽  
Secondary Analysis ◽  
Observation Time ◽  
Incidence Density ◽  
Future Research ◽  
Mortality Data ◽  
Primary Analysis ◽  
California Department ◽  
Firearm Suicide

Abstract Background Firearms are the most lethal method of suicide and account for approximately half of all suicide deaths nationwide. We describe associations between firearm purchasing characteristics and firearm suicide. Methods Data on all legal handgun transactions in California from 1996 to 2015 were obtained from the California Department of Justice Dealer’s Record of Sale database. Handgun purchasers were linked to mortality data to identify those who died between 1996 and 2015. To account for variation in timing and duration of observation time, analyses were stratified by birth cohort. The primary analysis focused on those aged 21–25 in 1996. A secondary analysis tested associations among those aged 50–54 in 1996. Using incidence density sampling, purchasers who died by firearm suicide (cases) were each gender-matched to 5 purchasers (controls) who remained at risk at the case’s time of death. We examined the characteristics of purchasers and transactions, focusing on the transaction closest in time to the case’s death. Data were analyzed with conditional logistic regression. Results There were 390 firearm suicides among the younger cohort and 512 firearm suicides among the older cohort. Across both cohorts, older age at first purchase and the purchase of a revolver were associated with greater risk of firearm suicide. For example, among the younger cohort, those who purchased a revolver versus semiautomatic pistol had 1.78 times the risk of firearm suicide (95% CI 1.32, 2.40) in multivariable models. Other associations varied across cohorts, suggesting cohort or age effects in purchasing patterns. Conclusions Findings add to the evidence on firearm suicide risk and may help inform prevention strategies and future research.

scholarly journals Helmet fit assessment and concussion risk in youth ice hockey players: A Nested Case-Control Study

2020 ◽  
Author(s):  
Alexander S.D. Gamble ◽  
Jessica L. Bigg ◽  
Stacy Sick ◽  
Maciek Krolikowski ◽  
Declan A. Patton ◽  
...  
Keyword(s):  
Conditional Logistic Regression ◽  
Case Control ◽  
Injury Surveillance ◽  
Ice Hockey ◽  
Future Research ◽  
Control Group ◽  
Primary Analysis ◽  
Injury Surveillance System ◽  
Hockey Players ◽  
Nested Case Control

ABSTRACT Context: Injury surveillance has shown that concussions are the most common injury in youth ice hockey. Research examining criteria to ensure correct fit of protective equipment and its potential relationship with concussion risk is very limited. Objective: To evaluate the association between helmet fit and odds of concussion in youth ice hockey players. Design: Nested case-control in a cohort study. 10 Setting: COUNTRY-XXX. Participants: Data were collected for 72 concussed, 41 non-concussion injured, and 62 uninjured ice hockey players ages 11–18 years. Main Outcome Measures: Helmet fit assessments were conducted across players encompassing helmet specifications, condition, certification, and criteria measuring helmet fit. Using a validated injury surveillance system, cases included players with suspected and/or physician-diagnosed concussion. One control group included players who sustained non-concussion injuries and a second control group included uninjured players. Helmet fit criteria (score/16) were assessed for concussed players and compared with each of two control groups. The primary outcome was dichotomous (>1 helmet fit criteria missing vs. 0 or 1 criteria missing). Logistic and conditional logistic regression were used to investigate the effect of helmet fit on odds of concussion. Results: The primary analysis (54 pairs matched for age, sex, and level of play) suggested that inadequate helmet fit (>1 criterion missing) resulted in greater odds of concussion when comparing concussed and uninjured players [OR: 2.67 (95% CI 1.04–6.81), p=0.040]. However, a secondary unmatched analysis including all participants suggested no significant association between helmet fit and odds of concussion when comparing concussed players with non-concussion injured players [OR: 0.98 (95% CI 0.43–2.24), p=0.961] or uninjured players [OR: 1.66 (95% CI 0.90–3.05), p=0.103]. Conclusion: Inadequate helmet fit may affect the odds of sustaining a concussion in youth ice hockey. Future research with larger sample sizes should continue to evaluate this relationship and inform helmet fit recommendations.

Hierarchical Modelling of Facial Perceptions: A Secondary Analysis of Aggressiveness Ratings

2020 ◽  
Author(s):  
Mark Christopher Adkins ◽  
Nataly Beribisky ◽  
Stephan Bonfield ◽  
Linda Farmus
Keyword(s):  
Factor Analysis ◽  
Mixed Model ◽  
Structural Information ◽  
Secondary Analysis ◽  
Specific Factor ◽  
Primary Analysis ◽  
Model Framework ◽  
Psychological Science ◽  
Individual Traits ◽  
Confirmatory Factor

The Psychological Science Accelerator’s (PSA) primary project tested for latent structure using exploratory factor analysis and confirmatory factor analysis but we decided to diverge from this approach and model individual traits separately. Our interest mainly was in examining the interplay between “stimulus ethnicity” and “stimulus sex” to discover how differing levels of these criterion differ across region, country, lab etc. While the necessary and prerequisite hierarchical structural information about each trait could certainly be found within the primary project’s dataset, we did not assume that any specific factor structure from the PSA’s primary analysis would necessarily hold, therefore we based our decision to model the data from each trait separately using a mixed model framework.

Has the SARS-CoV-2 outbreak had an impact on uptake of digital cessation support in UK smokers? An interrupted time series analysis (Preprint)

2020 ◽  
Author(s):  
Olga Perski ◽  
Aleksandra Herbec ◽  
Lion Shahab ◽  
Jamie Brown
Keyword(s):  
Time Series ◽  
Smoking Cessation ◽  
Secondary Analysis ◽  
Interrupted Time Series ◽  
Step Change ◽  
Outcome Variable ◽  
Primary Analysis ◽  
Increasing Trend ◽  
The Uk ◽  
Temporary Closure

BACKGROUND The SARS-CoV-2 outbreak may motivate smokers to attempt to stop in greater numbers. However, given the temporary closure of UK stop smoking services and vape shops, smokers attempting to quit may instead seek out digital support, such as websites and smartphone apps. OBJECTIVE We examined, using an interrupted time series approach, whether the SARS-CoV-2 outbreak has been associated with a step change or increasing trend in UK downloads of an otherwise popular smoking cessation app, Smoke Free. METHODS Data were from daily and non-daily adult smokers in the UK who had downloaded the Smoke Free app between 1 January 2020 and 31 March 2020 (primary analysis) and 1 January 2019 and 31 March 2020 (secondary analysis). The outcome variable was the number of downloads aggregated at the 12-hourly (primary analysis) or daily level (secondary analysis). The explanatory variable was the start of the SARS-CoV-2 outbreak, operationalised as 1 March 2020 (primary analysis) and 15 January 2020 (secondary analysis). Generalised Additive Mixed Models adjusted for relevant covariates were fitted. RESULTS Data were collected on 45,105 (primary analysis) and 119,881 (secondary analysis) users. In both analyses, there was no evidence for a step change or increasing trend in downloads attributable to the start of the SARS-CoV-2 outbreak. CONCLUSIONS In the UK, between 1 January 2020 and 31 March 2020, and between 1 January 2019 and 31 March 2020, there was no evidence that the SARS-CoV-2 outbreak has been associated with a surge in downloads of a popular smoking cessation app. CLINICALTRIAL osf.io/zan2s

Cultural variation in children's observation during a demonstration

2005 ◽  
Vol 29 (4) ◽  
pp. 282-291 ◽  
Author(s):  
Rebeca Mejía-Arauz ◽  
Barbara Rogoff ◽  
Ruth Paradise
Keyword(s):  
Secondary Analysis ◽  
Cultural Variation ◽  
Formal Schooling ◽  
Primary Analysis ◽  
Extensive Experience ◽  
Children’S Learning ◽  
Mexican Heritage ◽  
European Heritage ◽  
Us Children ◽  
Children's Learning

Ethnographic research indicates that in a number of cultural communities, children's learning is organised around observation of ongoing activities, contrasting with heavy use of explanation in formal schooling. The present research examined the extent to which first- to third-grade children observed an adult's demonstration of how to fold origami figures or observed the folding of two slightly older children who also were trying to make the figures, without requesting further information. In the primary analysis, 10 Mexican heritage US children observed without requesting additional information to a greater extent than 10 European heritage US children. Consistent with the ethnographic literature, these two groups differed in the extent of their family's involvement in schooling; hence, we explored the relationship with maternal schooling in a secondary analysis. An additional 11 children of Mexican heritage whose mothers had extensive experience in formal school (at least a high school education) showed a pattern more like that of the European heritage children, whose mothers likewise had extensive experience in school, compared with the Mexican heritage children whose mothers had only basic schooling (an average of 7.7 grades). The results suggest that a constellation of cultural traditions that organise children's learning experiences—including Western schooling—may play an important role in children's learning through observation and explanation.

Sub-Ethnicity and Survivorship Experience: Asian American Breast Cancer Survivors

2021 ◽  
pp. 019394592110319
Author(s):  
Wonshik Chee ◽  
Eun-Ok Im
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Asian American ◽  
Breast Cancer Survivors ◽  
Short Form ◽  
Secondary Analysis ◽  
Future Research ◽  
Japanese American ◽  
Personal Resource ◽  
Cancer Data

The purpose of the study was to explore the associations of sub-ethnicity to the survivorship experience of Asian American breast cancer survivors and identify the multiple factors that influenced their survivorship experience. This was a secondary analysis of the data among 94 Asian American breast cancer survivors from a larger ongoing study. Instruments included: questions on background characteristics, the perceived isolation scale, the Personal Resource Questionnaire, the Memorial Symptom Assessment Scale-Short Form, and the Functional Assessment of Cancer Therapy-Breast Cancer. Data were analyzed using hierarchical logistic and multiple regression analyses. After controlling for other factors, being a Japanese American (ref. = being a Chinese American) was significantly associated with pain scores (odds ratio [OR] = −0.32, p < .01), symptom distress scores ( β = −0.27, p < .01), and the quality of life scores ( β = 0.22, p = .03). Sub-ethnic variations in cultural attitudes, values, and beliefs need to be considered in future research/practice with Asian American breast cancer survivors.

Association between Number of Prior Cesareans and Early Preterm Delivery in Women with Abnormal Placentation

2020 ◽  
Author(s):  
Ayamo Oben ◽  
Elizabeth B. Ausbeck ◽  
Melissa N. Gazi ◽  
Akila Subramaniam ◽  
Lorie M. Harper ◽  
...  
Keyword(s):  
Preterm Delivery ◽  
Preterm Labor ◽  
Placenta Previa ◽  
Secondary Analysis ◽  
Blood Products ◽  
Primary Analysis ◽  
Logistic Regression Models ◽  
Placenta Accreta Spectrum ◽  
Nicu Admission ◽  
Early Preterm Birth

Objective Delivery timing at 34 to 36 weeks is nationally recommended for pregnancies complicated by placenta accreta spectrum (PAS). However, it has recently been suggested that those with ≥2 prior cesarean deliveries (CD) and PAS should be delivered earlier than 34 weeks because of a higher risk of unscheduled delivery and complications. We sought to evaluate whether the number of prior CD in women with PAS is associated with early preterm delivery (PTD) (<34 weeks). We also evaluated the same relationship in women with placenta previa alone (without PAS). Study Design This is a secondary analysis of a multicenter and observational study that included women with prior CD (maternal–fetal medicine unit cesarean registry). Women with a diagnosis of PAS (regardless of placenta previa) were included for our primary analysis, and women with known placenta previa (without a component of PAS) were independently analyzed in a second analysis. Two groups of patients from the registry were studied: patients with PAS (regardless of placenta previa) and patients with placenta previa without PAS. The exposure of interest was the number of prior CD: ≥2 CD compared with <2 CD. The primary outcome was PTD <34 weeks. Secondary outcomes included preterm labor requiring hospitalization or tocolysis, transfusion of blood products, composites of maternal and neonatal morbidities, and NICU admission. Outcomes by prior CD number groups were compared in both cohorts. Backward selection was used to identify parsimonious logistic regression models. Results There were 194 women with PAS, 97 (50%) of whom had <2 prior CD and 97 (50%) of whom had ≥2 prior CD. The rate of PTD <34 weeks in women with ≥2 prior CD compared with <2 in the setting of PAS was 23.7 versus 29.9%, p = 0.27; preterm labor requiring hospitalization was 24.7 versus 13.5%; p = 0.05. The rates of plasma transfusion were increased with ≥2 prior CD (29.9 vs. 17.5%, p = 0.04), but there were no differences in transfusion of other products or in composite maternal or neonatal morbidities. After multivariable adjustments, having ≥2 CDs was not associated with PTD <34 weeks in women with PAS (adjusted odds ratio (aOR): 0.73, 95% confidence interval [CI]: 0.39–13.8) despite an association with preterm labor requiring hospitalization (aOR: 2.69; 95% CI: 1.15–6.32). In our second analysis, there were 687 women with placenta previa, 633 (92%) with <2 prior CD, and 54 (8%) with ≥2 prior CD. The rate of PTD <34 weeks with ≥2 CD in the setting of placenta previa was not significantly increased (27.8 vs. 22.1%, aOR: 1.49; 95% CI: 0.77–2.90, p = 0.08); the maternal composite outcome (aOR: 4.85; 95% CI: 2.43–9.67) and transfusion of blood products (aOR: 6.41; 95% CI: 2.30–17.82) were noted to be higher in the group with ≥2 prior CD. Conclusion Women with PAS who have had ≥2 prior CD as compared with women with <2 prior CD did not appear to have a higher risk of complications leading to delivery prior to 34 weeks. As such, considering the associated morbidity with early preterm birth, we would not recommend scheduled delivery prior to 34 weeks in this population. Key Points

scholarly journals Endovascular thrombectomy time metrics in the era of COVID-19: observations from the Society of Vascular and Interventional Neurology Multicenter Collaboration

2021 ◽  
pp. neurintsurg-2020-017205
Author(s):  
Alexandra L Czap ◽  
Alicia M Zha ◽  
Jacob Sebaugh ◽  
Ameer E Hassan ◽  
Julie G Shulman ◽  
...  
Keyword(s):  
Care Delivery ◽  
Control Period ◽  
Secondary Analysis ◽  
Primary Analysis ◽  
Vessel Occlusion ◽  
Endovascular Thrombectomy ◽  
Final Multivariable Model ◽  
Multivariable Regression ◽  
Multi Center Study ◽  
Multivariable Adjustment

BackgroundUnprecedented workflow shifts during the coronavirus disease 2019 (COVID-19) pandemic have contributed to delays in acute care delivery, but whether it adversely affected endovascular thrombectomy metrics in acute large vessel occlusion (LVO) is unknown.MethodsWe performed a retrospective review of observational data from 14 comprehensive stroke centers in nine US states with acute LVO. EVT metrics were compared between March to July 2019 against March to July 2020 (primary analysis), and between state-specific pre-peak and peak COVID-19 months (secondary analysis), with multivariable adjustment.ResultsOf the 1364 patients included in the primary analysis (51% female, median NIHSS 14 [IQR 7–21], and 74% of whom underwent EVT), there was no difference in the primary outcome of door-to-puncture (DTP) time between the 2019 control period and the COVID-19 period (median 71 vs 67 min, P=0.10). After adjustment for variables associated with faster DTP, and clustering by site, there remained a trend toward shorter DTP during the pandemic (βadj=-73.2, 95% CI −153.8–7.4, Pp=0.07). There was no difference in DTP times according to local COVID-19 peaks vs pre-peak months in unadjusted or adjusted multivariable regression (βadj=-3.85, 95% CI −36.9–29.2, P=0.80). In this final multivariable model (secondary analysis), faster DTP times were significantly associated with transfer from an outside institution (βadj=-46.44, 95% CI −62.8 to – -30.0, P<0.01) and higher NIHSS (βadj=-2.15, 95% CI −4.2to – -0.1, P=0.05).ConclusionsIn this multi-center study, there was no delay in EVT among patients treated for intracranial occlusion during the COVID-19 era compared with the pre-COVID era.

scholarly journals FRI0421 RATES OF PROGRESSION DIFFER BETWEEN STRUCTURAL PHENOTYPES OF KNEE OSTEOARTHRITIS: A SECONDARY ANALYSIS FROM THE FNIH COHORT

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 808.1-809
Author(s):  
F. Roemer ◽  
J. Collins ◽  
T. Neogi ◽  
M. Crema ◽  
A. Guermazi
Keyword(s):  
Subchondral Bone ◽  
Radiographic Progression ◽  
Conditional Logistic Regression ◽  
Secondary Analysis ◽  
Sensitivity Analyses ◽  
Case Group ◽  
Composite Outcome ◽  
Bone Phenotype ◽  
Increased Risk ◽  
Inflammatory Phenotype

Background:Imaging plays an important role in determining structural disease severity and potential suitability of patients recruited to disease-modifying osteoarthritis drug (DMOAD) trials. It has been suggested that there may be three main structural phenotypes in OA, i.e., inflammation, meniscus/cartilage and subchondral bone. These may progress differently and may represent distinct tissue targets for DMOAD approaches.Objectives:To stratify the Foundation for National Institutes of Health Osteoarthritis Biomarkers Consortium (FNIH) cohort, a well-defined subsample of the larger Osteoarthritis Initiative (OAI) study, into distinct structural phenotypes based on semiquantitative MRI assessment and to determine their risk for progression over 48 months.Methods:The FNIH was designed as a case-control study with knees showing either 1) radiographic and pain progression (i.e., “composite” cases), 2) radiographic progression only (“JSL”), 3) pain progression only, and 4) neither radiographic nor pain progression. MRI of both knees was performed on 3 T systems at the four OAI clinical sites. Two musculoskeletal radiologists read the baseline MRIs according to the MOAKS scoring system. Knees were stratified into subchondral bone, meniscus/cartilage and inflammatory phenotypes1. A secondary, less stringent definition for inflammatory and meniscus/cartilage phenotype was used for sensitivity analyses. The relation of each phenotype to risk of being in the JSL or composite case group compared to those not having that phenotype was determined using conditional logistic regression. Only KL2 and 3 and those without root tears were included.Results:485 knees were included. 362 (75%) did not have any phenotype, while 95 (20%) had the bone phenotype, 22 (5%) the cartilage/meniscus phenotype and 19 (4%) the inflammatory phenotype. The bone phenotype was associated with a higher risk of the JSL and composite outcome (OR 1.81;[95%CI 1.14,2.85] and 1.65; 95%CI [1.04,2.61]) while the inflammatory (OR 0.96 [95%CI 0.38,2.42] and 1.25; 95%CI [0.48,3.25]) and the meniscus/cartilage phenotypes were not (OR 1.30 95%CI [0.55,3.07] and 0.99; 95%CI [0.40,2,49]).In sensitivity analyses, the bone phenotype and having two phenotypes (vs. none) were both associated with increased risk of experiencing the composite outcome (bone: OR 1.65; 95% CI 1.04, 2.61; 2 phenotypes: OR 1.87; 95% CI 1.11, 3.16.Conclusion:The bone phenotype was associated with increased risk of having both radiographic and pain progression together, or radiographic progression alone, whereas the inflammatory phenotype or meniscus/cartilage phenotype each individually were not associated with either outcome. Phenotypic stratification appears to provide insights into risk for structural or composite structure plus pain progression, and therefore may be useful to consider when selecting patients for inclusion in clinical trials.References:[1]Roemer FW, Collins J, Kwoh CK, et al. MRI-based screening for structural definition of eligibility in clinical DMOAD trials: Rapid OsteoArthritis MRI Eligibility Score (ROAMES). Osteoarthritis Cartilage 2020;28(1):71-81Disclosure of Interests:Frank Roemer: None declared, Jamie Collins Consultant of: Boston Imaging Core Lab (BICL), LLC., Tuhina Neogi Grant/research support from: Pfizer/Lilly, Consultant of: Pfizer/Lilly, EMD-Merck Serono, Novartis, Michel Crema: None declared, Ali Guermazi Consultant of: AventisGalapagos, Pfizer, Roche, AstraZeneca, Merck Serono, and TissuGene

scholarly journals A systematic review of the latent structure of the Center for Epidemiologic Studies Depression Scale (CES-D) amongst adolescents

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Joanna M. Blodgett ◽  
Chantelle C. Lachance ◽  
Brendon Stubbs ◽  
Melissa Co ◽  
Yu-Tzu Wu ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Cultural Differences ◽  
Factor Structure ◽  
English Language ◽  
Depression Scale ◽  
Epidemiologic Studies ◽  
Latent Structure ◽  
Future Research ◽  
Primary Analysis ◽  
The Usa

Abstract Background The Centre for Epidemiologic Studies Depression Scale (CES-D) is a commonly used psychometric scale of depression. A four-factor structure (depressed affect, positive affect, somatic symptoms, and interpersonal difficulties) was initially identified in an American sample aged 18 to 65. Despite emerging evidence, a latent structure has not been established in adolescents. This review aimed to investigate the factor structure of the CES-D in adolescents. Methods We searched Web of Science, PsychINFO and Scopus and included peer-reviewed, original studies assessing the factor structure of the 20-item CES-D in adolescents aged ≤18. Two independent researchers screened results and extracted data. Results Thirteen studies met the inclusion criteria and were primarily from school-based samples in the USA or Asia. Studies that conducted confirmatory factor analysis (CFA; n = 9) reported a four-factor structure consistent with the original factor structure; these studies were primarily USA-based. Conversely, studies that conducted exploratory factor analysis (EFA) reported distinct two or three factor structures (n = 4) and were primarily based in Asia. Limitations Studies in a non-English language and those that included individuals aged > 18 years were excluded. Ethnic or cultural differences as well as different analytical methods impacted generalisability of results. The use of CFA as the primary analysis may have biased towards a four-factor structure. Conclusions A four-factor CES-D structure was an appropriate fit for adolescents in Western countries; further research is required to determine the fit in in Asian countries. This has important implications for clinical use of the scale. Future research should consider how cultural differences shape the experience of depression in adolescents.

071 Natalizumab extended interval dosing (EID) is associated with a significant reduction in progressive multifocal leukoencephalopathy (PML) risk compared with standard interval dosing (SID) in the touch® prescribing program

2018 ◽  
Vol 89 (6) ◽  
pp. A29.2-A29 ◽  
Author(s):  
Lana Zhovtis Ryerson ◽  
John Foley ◽  
Ih Chang ◽  
Ilya Kister ◽  
Gary Cutter ◽  
...  
Keyword(s):  
Cox Regression ◽  
Jc Virus ◽  
Secondary Analysis ◽  
Statistical Analysis Plan ◽  
Rank Test ◽  
Primary Analysis ◽  
Standard Interval ◽  
Kaplan Meier ◽  
Hazard Ratios ◽  
Dosing Intervals

IntroductionNatalizumab, approved for 300 mg intravenous every-4-weeks dosing, is associated with PML risk. Prior studies have been inconclusive regarding EID’s impact on PML risk. The US REMS program (TOUCH) offers the largest data source that can inform on PML risk in patients on EID. This analysis aimed to determine whether natalizumab EID is associated with reduced PML risk compared with SID.MethodsInvestigators developed SID and EID definitions and finalised the statistical analysis plan while blinded to PML events. Average dosing intervals (ADIs) were ≥3 to<5 weeks for SID and >5 to≤12 weeks for EID. The primary analysis assessed ADI in the last 18 months of infusion history. The secondary analysis identified any prolonged period of EID at any time in the infusion history. The tertiary analysis assessed ADI over the full infusion history. Only anti-JC virus antibody positive (JCV Ab+) patients with dosing intervals≥3 to≤12 weeks were included. PML hazard ratios (HRs) were compared using adjusted Cox regression models and Kaplan-Meier estimates.ResultsAnalyses included 13,132 SID and 1988 EID patients (primary), 15,424 SID and 3331 EID patients (secondary), and 23,168 SID and 815 EID patients (tertiary). In primary analyses, ADI (days) was 30 for SID and 37 for EID; median exposure (months) was 44 for SID and 59 for EID. Most EID patients received >2 years SID prior to EID. The PML HR (95% CI) was 0.06 (0.01–0.22; p<0.001) for primary analysis and 0.12 (0.05–0.29; p<0.001) for secondary analysis (both in favour of EID); no EID PML cases were observed in tertiary analyses (Kaplan-Meier log-rank test p=0.02).ConclusionIn JCV Ab +patients, natalizumab EID is associated with a clinically and statistically significant reduction in PML risk as compared with SID. As TOUCH does not collect effectiveness data, further studies are needed.Study supportBiogen

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