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The natural history of MS 

The natural history of MS
Chapter:
The natural history of MS
Author(s):

John Zajicek

, Jennifer Freeman

, and Bernadette Porter

DOI:
10.1093/med/9780198569831.003.0006
Page of

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date: 22 August 2019

What is natural history? 26

Death from MS 28

Disability 28

Factors predicting outcome 28

The natural history of a disease is derived from studies of a population of people with that condition, identified as near as possible to the start of the condition and followed-up longitudinally over as many years as possible, using appropriate measurements. In chronic diseases such as MS these studies can be fraught with difficulties, including adequate case ascertainment (making sure that the investigators have found as many people as possible with MS in the population under study), good long-term follow-up with low rates of dropout (to reduce bias), and choosing the correct measurement instruments. Bias can be introduced by, for example, not taking proper account of mildly affected or severely affected individuals. The introduction of new treatments may also influence the natural history of the condition, a factor relevant in recent years. More broad changes in healthcare may mean that interpreting data derived from cohorts of patients identified 30 years ago may well be different to data derived from patients diagnosed in the twenty-first century....

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