Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Varosanec, M.
Analysis of a Regional Multiple Sclerosis Database
[ Diplomarbeit ] Graz Medical University; 2013. pp. 65
[OPEN ACCESS]
FullText
- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Enzinger Christian
- Fazekas Franz
- Altmetrics:
- Abstract:
- Abstract Background: In medicine electronic databases have become an important instrument for the understanding and management of specific disorders. Such national and international databases are also used for the follow up of patients with Multiple Sclerosis (MS). In Austria the medical care for MS patients is performed predominantly in so-called Multiple Sclerosis Centers, which provide diagnosis and therapeutic management for each individual patient. A documentation of patients undergoing immunemodulatory therapy (IMT) was advised by the Health Insurance Association. Objective: For the Department of Neurology Bruck an der Mur, as per order, an electronic database was developed to fulfill the tasks described above. In this thesis, the formation, structure, entry procedure and automated analysis of the data are presented. Furthermore, the database was evaluated regarding the degree of fulfillment of its objectives and in terms of clinical relevance. In particular practicality and feasibility should be analyzed and it was looked which data can be easily accessed and read. Special features of the database were compared to other frequently used databases and emphasized in more depth. At the same time it was tried to identify possible weaknesses and improvements. Methods: This registry was developed in the Microsoft Access Application which is commonly used worldwide. The database served to document patients who were diagnosed with Multiple Sclerosis and who started and an appropriate treatment. The diagnosis of MS is based on the international criteria by Poser & McDonald. The usage of specific MS ¿ therapies is based on recommendations of the MS ¿ Association in the German speaking region of Europe, available literature and ultimately depends on the decisions of the physicians in charge. The amount of data registered in the database and the data congruency of those entries were verified by Microsoft Access queries. Those values, gathered by the automated analysis, were then summarized in tables. Results: 303 patients were registered in the database described herein. 218 were women, 85 were men. 268 patients were diagnosed with MS and classified according to the particular MS-subtypes. In the automated group-analysis the overall number of patients was assigned to the following MS ¿ subtypes: Clinically Isolated Syndrome (CIS): 34, Relapse Remitting MS (RRMS): 212, Secondary Progressive MS (SPMS): 16, Primary Progressive MS (PPMS): 6. In this analysis of the database 212 patients who had a definitive MS diagnosis and a specific MS-therapy were included. The graphic display of the progress of the EDSS score, the relapse-frequency and ¿duration provide a good overview of the clinical progression of the individual patient. The period of time between the diagnosis and the first applied immunemodulatory therapy (IMT) averages 2,27 years. From the 212 treated patients, a subgroup of 155 patients who were treated with IMT for a minimum of two years and a maximum of nine years was selected. The average therapy-duration for these patients, in the analysis period of the database, was 5,2 years. For this group 823 MRI-studies were performed and the pictures with higher significance and findings were imported to the database for future comparisons. In some datafields, problems with the format or even empty fields were noted. Conclusions: The electronic database which has been implemented for the follow-up of MS-patients from the LKH Bruck an der Mur shows a good overview of the clinical progression for each patient. Also, the use of specific immunemodulatory therapies, treatment duration and EDSS progression was well documented. In the future, an increase of resources in terms of staff members and time for such projects should be considered to guarantee consecutive inclusion of patients and avoid missing data