Author/Authors :
Ghadiri ، Fereshteh Multiple Sclerosis Research Center, Neuroscience Institute - Tehran University of Medical Sciences , Asadollahzadeh ، Elnaz Multiple Sclerosis Research Center, Neuroscience Institute - Tehran University of Medical Sciences , Ebadi ، Zahra Multiple Sclerosis Research Center, Neuroscience Institute - Tehran University of Medical Sciences , Sahraian ، Mohammad Ali Multiple Sclerosis Research Center, Neuroscience Institute - Tehran University of Medical Sciences , Azimi ، Amirreza Multiple Sclerosis Research Center, Neuroscience Institute - Tehran University of Medical Sciences , Navardi ، Samira Multiple Sclerosis Research Center, Neuroscience Institute - Tehran University of Medical Sciences , Heidari ، Hora Multiple Sclerosis Research Center, Neuroscience Institute - Tehran University of Medical Sciences , Abna ، Zohreh Multiple Sclerosis Research Center, Neuroscience Institute - Tehran University of Medical Sciences , Aboutorabi ، Marzieh Department of Neurology - Shahid Sadoughi Hospital - Shahid Sadoughi University of Medical Sciences , Adibi ، Iman Department of Neurology - School of Medicine, Isfahan Neurosciences Research Center - Isfahan University of Medical Sciences , Baghbanian ، Mohammad Department of Neurology - Booalicina Hospital - Mazandaran University of Medical Sciences , Paybast ، Sepideh Multiple Sclerosis Research Center, Neuroscience Institute - Tehran University of Medical Sciences , Poursadeghfard ، Maryam Clinical Neurology Research Center - Shiraz University of Medical Sciences , Hosseini ، Samaneh Neurosciences Research Center - Tabriz University of Medical Sciences , Shahmohammadi ، Sareh Multiple Sclerosis Research Center, Neuroscience Institute - Tehran University of Medical Sciences , Ghaffari ، Mehran Department of Neurology - School of Medicine - Shahid Beheshti University of Medical Sciences , Ghalyanchi-Langroodi ، Hamidreza Center for Clinical Research and Development - Ghaem International Hospital , Ghiasian ، Masoud Department of Neurology - School of Medicine - Hamadan University of Medical Sciences , Kamali ، Hoda Neurology Research Center - Kerman University of Medical Sciences , Kouchaki ، Ebrahim Department of Neurology - School of Medicine - Kashan University of Medical Sciences , Mehrabi ، Farzad Department of Neurology - Imam Reza Hospital - AJA University of Medical Sciences , Mohammadianinejad ، Ehsan Multiple Sclerosis Research Center, Neuroscience Institute - Tehran University of Medical Sciences , Nahayati ، Mohammad Ali Department of Neurology - Ghaem Hospital - Mashhad University of Medical Sciences , Naser Moghadasi ، Abdorreza Multiple Sclerosis Research Center, Neuroscience Institute - Tehran University of Medical Sciences
Abstract :
Background: People with multiple sclerosis (MS) and their physicians recognize cognitive retention as an important desired outcome of disease-modifying therapies (DMTs). In this study, we attempted to gather the opinions of Iranian MS experts regarding the treatment approach toward clinical cases with different physical and cognitive conditions. Methods: Opinions of 20 MS specialists regarding the best approach to 6 case scenarios (with different clinical, cognitive, and imaging characteristics) were gathered via a form. Results: The estimated kappa of 0.16 [95% confidence interval (CI): 0.159-0.163; P 0.001] suggested a poor degree of agreement on the treatment choice among the professionals. Conclusion: Although most specialists agreed with treatment escalation in cases with cognitive impairment, there was no general agreement. Furthermore, there was not enough clinical evidence in the literature to develop consensus guidelines on the matter.
Keywords :
Cognitive Dysfunction , Multiple Sclerosis , Treatment Escalation , Specialist , Iran
