Fereshteh Ghadiri, Elnaz Asadollahzadeh, Zahra Ebadi, Mohammad Ali Sahraian, Amirreza Azimi, Samira Navardi, Hora Heidari, Zohreh Abna, Marzieh Aboutorabi, Iman Adibi, Seyed Mohammad Baghbanian, Sepideh Paybast, Maryam Poursadeghfard, Samaneh Hosseini, Sareh Shahmohammadi, Mehran Ghaffari, Hamidreza Ghalyanchi-Langroodi, Masoud Ghiasian, Hoda Kamali, Ebrahim Kouchaki, Farzad Mahrabi, Ehsan Mohammadianinejad, Mohammad Ali Nahayati, Abdorreza Naser Moghadasi
{"title":"伊朗专家对认知障碍多发性硬化症患者治疗升级的方法","authors":"Fereshteh Ghadiri, Elnaz Asadollahzadeh, Zahra Ebadi, Mohammad Ali Sahraian, Amirreza Azimi, Samira Navardi, Hora Heidari, Zohreh Abna, Marzieh Aboutorabi, Iman Adibi, Seyed Mohammad Baghbanian, Sepideh Paybast, Maryam Poursadeghfard, Samaneh Hosseini, Sareh Shahmohammadi, Mehran Ghaffari, Hamidreza Ghalyanchi-Langroodi, Masoud Ghiasian, Hoda Kamali, Ebrahim Kouchaki, Farzad Mahrabi, Ehsan Mohammadianinejad, Mohammad Ali Nahayati, Abdorreza Naser Moghadasi","doi":"10.18502/cjn.v22i1.12610","DOIUrl":null,"url":null,"abstract":"<p><p><b>Background:</b> 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. <b>Methods:</b> 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. <b>Results:</b> 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. <b>Conclusion:</b> 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.</p>","PeriodicalId":40077,"journal":{"name":"Current Journal of Neurology","volume":null,"pages":null},"PeriodicalIF":0.5000,"publicationDate":"2023-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10444593/pdf/","citationCount":"0","resultStr":"{\"title\":\"Iranian specialists' approach to treatment escalation in multiple sclerosis patients with cognitive impairment.\",\"authors\":\"Fereshteh Ghadiri, Elnaz Asadollahzadeh, Zahra Ebadi, Mohammad Ali Sahraian, Amirreza Azimi, Samira Navardi, Hora Heidari, Zohreh Abna, Marzieh Aboutorabi, Iman Adibi, Seyed Mohammad Baghbanian, Sepideh Paybast, Maryam Poursadeghfard, Samaneh Hosseini, Sareh Shahmohammadi, Mehran Ghaffari, Hamidreza Ghalyanchi-Langroodi, Masoud Ghiasian, Hoda Kamali, Ebrahim Kouchaki, Farzad Mahrabi, Ehsan Mohammadianinejad, Mohammad Ali Nahayati, Abdorreza Naser Moghadasi\",\"doi\":\"10.18502/cjn.v22i1.12610\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Background:</b> 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. <b>Methods:</b> 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. <b>Results:</b> 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. <b>Conclusion:</b> 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.</p>\",\"PeriodicalId\":40077,\"journal\":{\"name\":\"Current Journal of Neurology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.5000,\"publicationDate\":\"2023-01-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10444593/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Current Journal of Neurology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.18502/cjn.v22i1.12610\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Journal of Neurology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.18502/cjn.v22i1.12610","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Iranian specialists' approach to treatment escalation in multiple sclerosis patients with cognitive impairment.
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.
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