![]() ![]() ![]() But hospital- and clinic-based series, although open to referral bias – tending towards over-representation of more severe cases (S. As a result, the sample is population based and fully representative of variations in the disease, within the confines of definition and classification. Ideally, this means that all examples of the disease living in a well-defined geographical area have been ascertained and included in the cohort. That said, more work is still needed to characterize the natural history of multiple sclerosis and, especially, to resolve whether or not the so-called ‘disease modifying agents’ do in fact really modify the course of multiple sclerosis.Īn essential prerequisite for obtaining relevant information concerning the natural history is to deal with a source population that can be considered representative of the disease as a whole. Nevertheless, this knowledge allows inferences reliably to be drawn regarding the pathophysiology of the disease it provides information needed by public health services wanting to calculate disease costs and decide on investments in health care resources it guides health insurance companies with respect to disability and life expectancy calculations it sets the pharmaceutical industry agenda for investment in research and development programmes and it plays an essential role in the evaluation of efficacy in clinical trials. However, these features apply more consistently to groups than to individual patients. But there has been a real dividend from recent efforts to define and validate features that predict the future course and, as a result, authoritative data on the natural history are now available. Poser debut ask for serial number when opening professional#A detailed knowledge of the overall course and prognosis is therefore desirable for the physician wanting to understand the disease and make it comprehensible to the individual patient facing decisions on personal, family, social or professional involvements and commitments. Nothing seems to be entirely similar or fully predictable. ![]() ![]() The clinical features are extremely variable and the prognosis unpredictable. Simply stated, multiple sclerosis develops early, and runs a protracted clinical course so that life expectancy is barely reduced. With such a richness of material, our knowledge in this field is materially greater than for any other chronic disease. Poser et al 1986 Riise et al 1988 1992 Riser et al 1971 Runmarker and Andersen 1993 Runmarker et al 1994b A.J. Miller et al 1992a Minderhoud et al 1988 R. Clark et al 1982 Confavreux et al 1980 1998a 2000 20 Fog and Linnemann 1970 Goodkin et al 1989 Kantarci et al 1998 Kremenchutzky et al 1999 Kurtzke 1956 1965b 1970 Kurtzke et al 1968a 1969 1970a 1973 1977 Leibowitz and Alter 1973 McAlpine 1946 1961 1964 McAlpine and Compston 1952 McDonnell and Hawkins 1998b D.H. Allison 1950 Amato et al 1999 Bonduelle 1967 Bonduelle and Albaranès 1962 V.A. Many authors have collected large numbers of cases and described the overall course and prognosis of multiple sclerosis (R.S. ![]()
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