Problems of Experimental Trials of Therapy in Multiple Sclerosis: Report by the Panel on the Evaluation of Experimental Trials of Therapy in Multiple Sclerosis

Schumacher, George A.; Beebe, Gilbert W.; Kibler, Robert F.; Kurland, Leonard T.; Kurtzke, John F.; McDowell, Fletcher; Nagler, Benedict; Sibley, W. A.; Tourtellotte, Wallace W.; Willmon, Thomas L.

doi:10.1111/j.1749-6632.1965.tb20235.x

Cited by 1,262 publications

(293 citation statements)

References 19 publications

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“…The Schumacher Committee recommendations issued in 1965 were purely clinical, 3 while the Poser Committee revision of 1983 incorporated laboratory as well as clinical criteria. 4 Most recently, the various iterations of the McDonald Committee criteria (2001,2005,2010) used MRI (Gd+ lesions, new T2 lesions) and other laboratory findings in addition to purely clinical criteria for disease diagnosis.…”

Section: Background Historical Evolution Of Ms Diagnostic Criteriamentioning

confidence: 99%

Use of Magnetic Resonance Imaging as Well as Clinical Disease Activity in the Clinical Classification of Multiple Sclerosis and Assessment of Its Course

Cook¹,

Dhib‐Jalbut²,

Dowling³

et al. 2012

International Journal of MS Care

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It has recently been suggested that the Lublin-Reingold clinical classification of multiple sclerosis (MS) be modified to include the use of magnetic resonance imaging (MRI). An international consensus conference sponsored by the Consortium of Multiple Sclerosis Centers (CMSC) was held from March 5to 7, 2010, to review the available evidence on the need for such modification of the Lublin-Reingold criteria and whether the addition of MRI or other biomarkers might lead to a better understanding of MS pathophysiology and disease course over time. The conference participants concluded that evidence of new MRI gadolinium-enhancing (Gd+) T1-weighted lesions and unequivocally new or enlarging T2-weighted lesions (subclinical activity, subclinical relapses) should be added to the clinical classification of MS in distinguishing relapsing inflammatory from progressive forms of the disease. The consensus was that these changes to the classification system would provide more rigorous definitions and categorization of MS course, leading to better insights as to the evolution and treatment of MS. Int J MS Care. 2012;14:105-114. It was recently suggested by Lincoln et al. 1 that the Lublin-Reingold clinical classification of multiple sclerosis (MS) 2 for the assessment of MS phenotypes and patient evolution over time be modified to include magnetic resonance imaging (MRI). It was recommended that the classification incorporate the "conventional," generally available MRI techniques of gadolinium (Gd) T1-weighted sequences and dual-echo and fluid-attenuated inversion recovery (T2-weighted and FLAIR) images ( course over time and, in turn, more informed clinical trials and a better understanding of appropriate therapies.Prior to the meeting, a survey of members of the CMSC was conducted on the need to modify the Lublin-Reingold classification. Over a 1-week period, 141 responses were received, representing 16% of the CMSC members polled. The results were as follows: A total of 70% of respondents indicated that the LublinReingold classification did not sufficiently distinguish the different forms of MS; 87% felt that the LublinReingold classification did not sufficiently distinguish MS disease activity even within a given category of the disease; and 84% indicated that it would be useful to include certain subclinical indices of disease activity in the clinical classification, such as MRI gadoliniumother MRI modalities that are not currently widely available and other validated biomarkers might be added to the classification in the future.In response to the publication of Lincoln et al., 1 the Consortium of Multiple Sclerosis Centers (CMSC) sponsored an international consensus conference, which was held in Short Hills, New Jersey, from March 5 to 7, 2010. Participating in the conference were 28 invited MS experts from North and South America and Europe who were well versed in clinical trials, the management of MS, biostatistics, neuropathology, neuroimaging, and neuroimmunology. The goal of the meeting was to review the available...

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Section: Background Historical Evolution Of Ms Diagnostic Criteriamentioning

confidence: 99%

Use of Magnetic Resonance Imaging as Well as Clinical Disease Activity in the Clinical Classification of Multiple Sclerosis and Assessment of Its Course

Cook¹,

Dhib‐Jalbut²,

Dowling³

et al. 2012

International Journal of MS Care

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“…26 One hundred eight individuals responded to the survey. Baseline demographic information was collected from a confidentiality-protected MS clinic database, described elsewhere.…”

Section: Subjectsmentioning

confidence: 99%

Physical Activity Levels in People with Multiple Sclerosis in Saskatchewan

Currie¹,

Knox²,

Glazebrook³

et al. 2009

International Journal of MS Care

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A substantial body of literature supports the benefits of physical activity for people with multiple sclerosis (MS). This study examined the types and amounts of physical activity reported by a cross-sectional sample of people with MS in Saskatchewan, Canada. Individuals with MS who were seen in the Saskatoon Multiple Sclerosis Clinic in 2006 were mailed a physical activity survey. Demographic information was collected from a confidentiality-protected clinical database. The response rate was 38.2% (108 of 283). No statistically significant differences in baseline demographics were found between responders and nonresponders. Of the responders, 93.5% engaged in some form of moderate physical activity at least once per week. Of these, 15.7% participated in group classes (mean [SD], 2.35 [1.32] days per week), 63.9% performed a minimum of 15 minutes of self-directed continuous activity (mean [SD], 4.5 [1.8] days per week), and 88.0% accumulated short bouts of moderate physical activity totaling a minimum of 20 minutes daily (mean [SD], 5.4 [1.9] days per week). In addition, 28.7% of responders reported that daily self-care required moderate physical effort. Physical activity decreased with increasing disability. The majority of responders participated in regular physical activity when multiple types of activity are considered. All activity sources should be considered when examining activity levels of individuals with MS.

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“…These criteria have been developed first as research tools, but then adopted as criteria for use in routine clinical practice. Schumacher first proposed MS diagnostic criteria in 1965, 2 emphasising the key principles of two distinct episodes of neurological dysfunction lasting at least 24 hours, occurring at least one month apart, involving two separate areas of the central nervous system, as confirmed by history or examination. These principles are now better known as dissemination in time (DIT) and space (DIS).…”

Section: Introductionmentioning

confidence: 99%

Most Scottish neurologists do not apply the 2010 McDonald criteria when diagnosing multiple sclerosis

Lumley

Davenport²,

Williams³

2015

J R Coll Physicians Edinb

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Problems of Experimental Trials of Therapy in Multiple Sclerosis: Report by the Panel on the Evaluation of Experimental Trials of Therapy in Multiple Sclerosis

Cited by 1,262 publications

References 19 publications

Use of Magnetic Resonance Imaging as Well as Clinical Disease Activity in the Clinical Classification of Multiple Sclerosis and Assessment of Its Course

Use of Magnetic Resonance Imaging as Well as Clinical Disease Activity in the Clinical Classification of Multiple Sclerosis and Assessment of Its Course

Physical Activity Levels in People with Multiple Sclerosis in Saskatchewan

Most Scottish neurologists do not apply the 2010 McDonald criteria when diagnosing multiple sclerosis

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