Research by Dr Francisco Javier Carod Artel, winner of MS MasterClass intermodule project award 2018

All of our attendees carry out a piece of research in an area of MS clinical practice or treatment that interests them.

This project won the MS Academy MasterClass Project Award for 2018, and this snapshot gives you a quick idea of what they found and why. If you want to learn more, just click through to the full research report, or follow the links within the snapshot.
If you would like to contact the alumni who did the research, drop us a line and we’ll put you in touch where possible.

 

Aim

The main aim of the research was to get an up-to-date picture of MS in the Scottish Highlands. The researcher had a second aim of finding out the amount of time it took a patient to both get a diagnosis of MS, and access disease-modifying treatment (DMT).

Headlines

  • MS is the most common neurologically disabling condition in young people today. It is found more amongst people from Northern Europe or with that ancestry.
  • A huge variety of data was looked at to get an accurate picture of MS in the Highlands, from registers and computer records, to historical studies, to liaison with professionals working in MS.
  • The research specifically wanted to find the number of people newly diagnosed in a year (incidence), and the number of people living with MS in total (prevalence).
    • To find the incidence, hospital registers were examined in a 12 month period (1st Jan-31st Dec 2016)
    • To find the prevalence, a cross-section of patients from the hospitals serving the Highlands in 2016 was looked at.

Key findings

  • Prevalence and incidence of MS in the Highlands has increased in the last 50 years:
    • Compared with data from 1960’s (Orkney) this study found the rate of MS in the Highlands to be three times higher. (National research suggests a rise in MS of 2.4% each year.)
    • In comparison to other Scottish areas, the Highlands were similar to Shetland (2009) and higher than Aberdeen (2012).
    • The Highland incidence rate was higher than the UK average with a noticeable increase in the number of newly diagnosed people. (full report, scroll to section 6, paragraph 5)
    • The average age of people at diagnosis fits with the national picture.
  • The number of people on DMTs was slightly lower than a comparative study in Northern Ireland where two thirds of MS patients were on DMTs.
  • People with more advanced or severe MS are not always seen regularly at MS clinics, and so might have been ‘missed’ in the data gathering, affecting how accurate the total numbers found.
  • Other specific gaps in information found were:
    • evidence of childhood MS.
    • causes of death for people with MS,

This research notes:

  • There are a number of reasons why this study has found an increase in the number of people living with MS in the Highlands:
    • differences in studies over time
    • improvements to diagnosis
    • improved survival
    • more people developing new cases of MS
    • changes in how people move geographically
  • Future studies on incidence and prevalence might be affected by the 2018 change to clinical criteria for diagnosing MS. (This change gives a diagnosis of MS to patients with a clinical isolated syndrome (CIS) who have positive oligoclonal bands.)

Core recommendations

  • There is clearly an increasing population living longer with MS which needs to affect how we use our resources in the Highlands.
  • Having an accurate picture of disability (by using sources like the Expanded Disability Status Scale EDSS) would also help in planning health care and services.
  • Future studies in this area need to consider:
    • gathering data from GP surgeries to pick up any people with advanced or secondary progressive MS not attending MS clinics.
    • consider the information gaps found around childhood MS, and mortality.

 

Take action

  • Read the full report
  • Contact the researcher to discuss their work (please put the name of the Snapshot as your title in our contact form)
  • Learn more about the issues raised in this report. Click the scattered links to access further information or see the researchers’ references here.