Health-care use before a first demyelinating event suggestive of a multiple sclerosis prodrome: a matched cohort study
The Lancet Neurology
DOI: http://dx.doi.org/10.1016/S1474-4422(17)30076-5
Published: 20 April 2017
José M A Wijnands, PhD, Elaine Kingwell, PhD, Feng Zhu, MSc, Yinshan Zhao, PhD, Tanja Högg, MSc, Karen Stadnyk, MSc, Okechukwu Ekuma, MSc, Xinya Lu, PhD, Charity Evans, PhD, John D Fisk, PhD, Prof Ruth Ann Marrie, MD, Prof Helen Tremlett, PhD
Background: degenerative processes in neurodegenerative diseases can start years before clinical manifestation. We aimed to establish whether a multiple sclerosis prodromal period exists by examining patterns of health-care use before a first demyelinating event.
Methods: in this matched cohort study, we used data from linked health administrative and clinical databases from four Canadian provinces (British Columbia, Saskatchewan, Manitoba, and Nova Scotia) to compare hospital, physician, and prescription use data…