Introduction by Dr Mike Boggild, The Walton Centre for Neurology and Neurosurgery
The National Library for Health, Annual Evidence Updates (AEU) attempt to draw together recently published, high quality evidence – focusing particularly on systematic reviews and published guidelines - which it is hoped will inform and enhance the decision making and planning of clinicians, commissioners and others involved in the process of health care.
For this Multiple Sclerosis (MS) AEU (pdf available for download) a detailed literature search from 2007-2008 identified 357 potential pieces of evidence (see methods for retrieving and evaluating the evidence for more information). Following a process of filtering and peer review (with thanks to the reviewers listed below) 27 of these form the basis of this AEU.
Though national guidelines for UK MS management in primary and secondary care were published in 2003 it is clear that there remain wide variations in the standard of care available to patients with MS (NHS Services for people with multiple sclerosis: a national survey). Arguably the 1990’s postcode lottery of access to disease modifying therapies has been replaced by a similar ‘postcode lottery of care’.
Against this background the disease area continues to rapidly evolve. The availability of increasingly effective - and higher risk - therapies such as Natalizumab provides challenges for service delivery, as indeed does the recognition of the importance of early diagnosis and intervention in selected patients for maximum therapeutic benefit.
It is imperative that those involved in commissioning and delivering care are apprised of the best available evidence and guidelines against which to review their service. We hope that the AEU in MS will provide a prime source of such evidence.
The evidence has been split into the following sections:
With thanks to the MS AEU reviewers:
Mike Boggild - Consultant Neurologist, Walton Centre for Neurology and Neurosurgery
Megan Burgess - MS Nurse Consultant, Salford Royal Hospitals NHS Trust
David Chadwick – former Professor of Neurology and Head of the School of Clinical Science of the University of Liverpool
Martin Duddy - Consultant Neurologist/Honorary Lecturer in Clinical Neurology, Royal Victoria Infirmary
Michelle Ennis - MS Clinical Specialist occupational therapist, Walton Centre, Liverpool
Bernadette Porter - Nurse Consultant, National Hospital for Neurology and Neurosurgery, UCLH
Jenny Thain - MS Clinical Specialist physiotherapist, The Walton Centre for Neurology and Neurosurgery
Martin Wilson – Consultant Neurologist, The Walton Centre for Neurology and Neurosurgery
Carolyn Young - Professor of Neurology, The Walton Centre for Neurology and Neurosurgery
Methods for retrieving and evaluating the evidence
