Fereshteh Ghadiri; Zahra Ebadi; Elnaz Asadollahzadeh; 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 Mehrabi; Ehsan Mohammadianinejad; Mohammad Ali Nahayati; Abdorreza Naser Moghadasi
Articles in Press, Accepted Manuscript, Available Online from 10 April 2023
Abstract
Background: Data on perioperative risk stratification in patients with multiple sclerosis (MS) are limited. In this regard, the present study was conducted to investigate Iranian specialists’ approach to surgical counseling for patients with MS (PwMS).Methods: 21 MS specialists were asked about ...
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Background: Data on perioperative risk stratification in patients with multiple sclerosis (MS) are limited. In this regard, the present study was conducted to investigate Iranian specialists’ approach to surgical counseling for patients with MS (PwMS).Methods: 21 MS specialists were asked about 11 case scenarios with different MS disease statuses, disease-modifying therapies (DMTs), and urgency of the operation. The reasons for refusing surgery or factors that have to be considered before surgery were studied.Results: Overall, Fleiss Kappa was estimated to be 0.091 [95% confidence interval (CI): 0.090-0.093, P < 0.001] indicating a very poor level of agreement among responders.Conclusion: PwMS face surgery for various reasons. Risk assessment of surgery, the effect of various drugs such as anesthetics and DMT on patients, as well as many other aspects of MS are issues challenging the practitioners. Clarifying the various dimensions of these issues requires further research.
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 Mehrabi; Ehsan Mohammadianinejad; Mohammad Ali Nahayati; Abdorreza Naser Moghadasi
Volume 22, Issue 1 , January 2023, , Pages 1-7
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 ...
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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.
Amirreza Azimi; Zohreh Abna; Fereshteh Ghadiri; Farzad Mehrabi
