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Well we have been talking about abstracts at the AAN this week, here's another contentious one to wet the appetite, before the weekend onslaught.
Warning this has not been properly Peer-Reviewed
its only an abstract not a paper
OBJECTIVE:
To assess opinions concerning CCSVI in a Canadian cohort of MS patients
and to determine whether a physician-designed educational tool would
change patient opinions.
BACKGROUND: Chronic Cerebrospinal Venous
Insufficiency (CCSVI) is the theory that extracranial venous occlusions
may give rise to multiple sclerosis (MS). A treatment involving venous
angioplasty has been developed based on this theory. Access to this
treatment, which remains controversial, has been widely demanded by MS
patients in Canada.
DESIGN/METHODS: A literature search was
conducted in September 2010. The results were incorporated into a
narrated slideshow video describing CCSVI and research performed to
date. 74 patients were randomized to watch either the physician-designed
video or a recent Canadian television documentary video on the topic.
All subjects were required to fill out the same questionnaire concerning
their opinions about CCSVI before and after observing the videos. The
primary outcome was defined as desire for CCSVI surgery.
RESULTS:
Overall 74 patients participated, mean age 44, median EDSS 3.5, with 36
randomized to the physician-designed video group and 38 to the
documentary video group. Seventy per cent desired CCSVI surgery before
watching the videos compared to 65% after. There was no significant
difference between the groups, either before or after viewing the video
(p=1.0 for “before” and “after”). Higher EDSS scores were associated
with desire for surgery (r=0.6, p<0.05).
CONCLUSIONS: A
significant majority of MS patients in Canada desire CCSVI surgery. A
review of the scientific evidence did not dissuade patients from their
desire for surgery, despite the fact that good evidence for its
efficacy does not exist. Desire for CCSVI surgery is correlated with
greater disability, presumably because of the lack of effective
conventional agents for more advanced disease.
I think the take home message suggests that people who are convinced of the validity of benefit
of CCSVI are unwavering in their passion for the treatment, even when there is no good evidence to support the view. Based on comments we get, I think that we do not need data to believe that this is the case. These are sometimes
balanced and thought-provoking sometimes threatening (I wish you would stop this please!....it does your case no
good) and sometimes just plain IG11.
Science
is about modifying your views as knowledge grows. Depending on the outcomes of the trials I am sure
there will be more clarity. If it does not work...shame and I am fine with this
and if it works great and I am fine with this also (Either way at present the outcome would not influence my research).
I wonder if there is
benefit from venoplasty, does this mean that CCSVI is the dogs bo***cks or
whether there could be an alternative explanation………..I think maybe. Let’s
see.
Over the weekend we will post the monthly round up of CCSVI so you can see if the recent research is suggesting that there is real (mystery) meat to the story or not.
As promised(John & Andy in Manchester) the Happy or Sad Zamboni are no more :-).
Labels: CCSVI