Naslov
Problems with diagnostic criteria for multiple sclerosis (editorial material)

Autori
Poser, C.M. ; Brinar, V.V.

Izvornik
Lancet 358 (2001), 9295; 1746-1747

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
multiple sclerosis; diagnostic criteria

Sažetak
Recommendations for new diagnostic criteria for multiple sclerosis (MS) have recently been developed by a group of neurologists from Austria, Canada, France, the Netherlands, the UK, and the USA. This effort is important because disease-modifying treatments are now widely given soon after diagnosis, so diagnosis should be accurate. The new criteria are intended to supersede those published in 1983. The two major changes are the incorporation of magnetic- resonance imaging (MRI) into the overall diagnostic scheme, and the addition of useful, much needed new guidelines for the diagnosis of primary progressive disease. No set of diagnostic criteria can identify every case of MS because of the enormous clinical variability of the disease. The 1983 criteria, which one of us helped to draw up, were specifically designed for epidemiological studies and therapeutic trials but became widely used in clinical practice. They were intended to complement the clinician’s experience and intuition. Changes in the cerebrospinal fluid, evoked responses, and imaging studies of the nervous system were also taken into account in this set of criteria. The impact of MRI on the diagnostic process and the increasing dependence on it, often at the expense of a detailed history and neurological examination, was not foreseen. Much reliance is being placed on reports by radiologists, who are not always specifically trained in the interpretation of MRI of the nervous system and may not have been provided with sufficient clinical information. Although the incorporation of MRI criteria represents the logical acceptance of important contribution of this technique to the understanding and diagnosis of the disease process, these MRI criteria are not underpinned y appropriate data. Barkhof and colleagues’ MRI findings have not been not validated for diagnosis of MS since they were a retrospective compilation of data used to predict.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA