This was a population-based study using the GPRD. No further ethical approval is required for studies using GPRD that do not involve patient contact.
This was a descriptive study. Its aim was to estimate the incidence and prevalence of MS by age in men and women and to describe secular trends and geographic variations within the UK between and The study population included all patients with acceptable data who contributed follow-up time to the database after GPRD defines a patient's data as unacceptable if there is evidence of poor data recording, non-contiguous follow-up or if their registration with the practice is temporary.
This is probably due to inclusion of patients with prevalent disease whose initial diagnosis pre-dated the computerisation of their practice's records. The follow-up period ended with the earlier of either their transfer-out date or their practice's last data collection date. Incident cases were defined as the first occurrence of a code for MS if it occurred after the 2-year screening period.
The analysis plan is shown in figure 1. For every patient, the number of days of follow-up available on the GPRD was calculated for each year from to We determined whether patients had any prior diagnosis of MS in the GPRD on the 1st January each year and, if not, whether any incident diagnosis occurred during the year. Incidence rates were estimated from Poisson regression models with log time at risk as an offset variable.
Prevalence rates were estimated from logistic regression models. The explanatory variables in the models were age, year and region.
Data for men and women were analysed separately. We estimated the prevalence and incidence of MS in these patients over this period of time using GPRD data only, as described above. We compared these rates with those calculated for the same patients using the additional diagnoses obtained from HES. These rates were used to adjust estimates of incidence and prevalence rates for the whole GPRD population. We applied these adjusted age-specific and gender-specific incidence and prevalence rates to population statistics obtained from the Office for National Statistics ONS for the UK population to estimate the absolute numbers of new and prevalent cases of MS in the UK population in To estimate the numbers of incident and prevalent cases of MS in the UK population in for men and women in each decade of life, we calculated incidence and prevalence rates in the entire GPRD population and applied age-specific correction factors to account for under-reporting in GP records alone.
The prevalence of MS increased by about 2. The prevalence rates that are below the trend line in the early s may be an artefact due to patients being first diagnosed before their entry to the database, despite the 2-year screening period. Secular trends in the prevalence of multiple sclerosis General Practice Research Database — There was a consistent downward trend in the incidence of MS in the whole study population over the year study period figure 3 A.
In , MS incidence in women fell to The rate of decline between and was 1. This implies that the female-to-male ratio among incident cases, approximately 2. Secular trends in the incidence of multiple sclerosis General Practice Research Database — A Incidence per 10 5 patient years in women and men all age groups.
Mortality rates fell in the GPRD population over the study period. In the 70—year age group, for example, they fell from 5. Among other age groups, the proportional decline was similar.
The mortality rate among patients with MS was more than twice that of other patients in all age groups and in both sexes, but also declined at a similar proportional rate. Life expectancy rose from We applied the age-specific mortality ratios for people with and without MS observed in the present study to estimate changes in life expectancies in people with MS over the same decade.
They increased from Incidence and prevalence of multiple sclerosis in women and men by age General Practice Research Database — A Incidence per 10 5 patient years. B Prevalence per 10 5 patients. The highest prevalence and incidence rates were observed in Scotland. Among the other 12 regions of the UK, latitude accounted for HES identified an additional prevalent cases and incident cases in men and prevalent cases and incident cases in women.
Age-specific correction factors were estimated. We also estimated the numbers of incident and prevalent cases of MS in the four countries which comprise the UK table 5. The overall prevalence of MS increased by approximately 2. We observed a decline in the rate at which new cases of MS were diagnosed, and the rising prevalence rate can likely be accounted for by trends in mortality rates. There was a consistent downward trend in overall incidence of MS in the whole study population over the year study period, and the rate of decline did not differ between men and women or with age.
It is possible that this is due to new diagnostic techniques which reduced the risk of false positive diagnoses over the study period. We were not able to analyse the effects of prior pregnancy on the age of onset of MS in women in this study, although it has previously been reported that pregnancy reduces the risk of onset of MS. We found the highest incidence and prevalence rates among the 13 regions of the UK in Scotland, but no trend with latitude among the other 12 regions.
This suggests that the difference between Scotland and other regions of the UK is probably not the result of a consistent trend with latitude, but may involve factors not associated with latitude. A major strength of this study is that it covers a representative sample of GPs spread geographically throughout the UK, and a patient population with age and sex distributions similar to those of the general UK population.
The study population of some 4 million patients provides greater statistical precision than earlier regional surveys.
Our analyses depend upon the accuracy of diagnosis and recording of MS by GPs: The prevalence rates we found are slightly higher than the rates reported by Thomas et al in , also using the GPRD: Alonso and colleagues reported incidence rates of 7. An overall incidence rate of MS of 3.
The downward trend in incidence that we found is in contrast to studies in Denmark, where the female incidence of MS has almost doubled since the s while male incidence has remained constant.
Moreover, separate surveys carried out and analysed at different times may be subject to methodological differences. It is not clear why our study has detected a decreasing incidence while others have suggested increasing incidence. Changes in awareness of MS and the challenges of diagnosing MS may account for changes incidence over time. However, we could identify no specific reason why the methodology or data source we used should have had an impact on our finding of decreasing incidence of MS over the period of the study.
In the current study, the mean female-to-male ratio for MS was 2. For example, a recent analysis of trends in the sex ratio in MS for individuals born between and found a marked increase in Northern Europe not including the UK from 2. This may be partly accounted for by changing health-related behaviours of men in recent years, perhaps having more contact with medical services than was the case historically.
We are not able to identify any particular reason why the study methodology or data source could have confounded our findings regarding sex-ratio. A recent study using HES data for the period — showed regional variations in hospital admission rates for MS in England. Early studies on MS suggested a trend with latitude with increasing prevalence in more temperate climates in Northern and Southern hemispheres. Regional variation in MS epidemiology may be due to genetic or environmental factors and interactions between them.
This is supported by studies on the effect of month of birth on subsequent risk of MS in Northern and Southern hemispheres. Further studies are needed to investigate the causative factors of MS, particularly the role of Vitamin D, genetic susceptibility factors and infective agents. This study provides a comprehensive picture of the prevalence and incidence of MS throughout the UK over two decades. It shows that more than people in the UK were newly diagnosed with MS in and that patients with MS are living longer, leading to a rising population living with the disease.
This has important implications for resource provision in the UK. All authors were involved in drafting and reviewing the manuscript. Statistical analysis was carried out by SVM. As a local Vernon home builder and Okanagan construction specialist of over 15 years, we know the value of producing real results through open communication from start to finish on every project.
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Multiple Sclerosis Research Papers delve into a sample of a paper ordered for an analysis of the degenerative disorder.
Introduction Multiple Sclerosis is a demyelization disorder of the central nervous system and the spinal cord; which leads to patches of plaques in the regions.
- This research paper, will discuss the pathophysiological, psychosocial, economic and cognitive effects which Multiple Sclerosis (MS) has on the affected individual, family and society. It will make mention of how a professional nurse would support the individual, the family/carer. View Multiple sclerosis Research Papers on bestqup2m.ga for free.
Health term papers (paper ) on Multiple Sclerosis A+ Research Paper : Introduction Multiple Sclerosis Stephanie **** Multiple Sclerosis (MS) is a chronic, often disabling disease that randomly attacks the ce. Term paper Incidence and prevalence of multiple sclerosis in the UK – a descriptive study in the General Practice Research Database I S Mackenzie, 1 S V Morant, 1 G A Bloomfield, .