Multiple Sclerosis Clinical Trial
Official title:
Decision Making in Multiple Sclerosis Care Under Uncertainty
The main objectives of this study are:
i) To determine patient-level, physician-level and health system factors influencing
therapeutic decisions in multiple sclerosis (MS) care by applying conjoint discrete
experiments.
ii) To determine the prevalence of therapeutic inertia among participating neurologists.
iii) To compare clinical judgement vs. a qualitative or quantitative approach when assessing
for a given case-scenario.
iv) To evaluate the influence of decision fatigue in treatment decisions.
The landscape of MS care is changing. Currently, there are over 15 disease modifying agents
(DMTs) available to treat MS, with varying availability around the world.
Significant heterogeneity exists in the efficacy and risks associated with these therapies.
Neurologists caring for MS patients face important choices in each medical encounter: 1)
continue with the same management, 2) initiate or escalate therapy for a more effective or
safer agent, or 3) consider a reassessment within months under the uncertainty of the current
status of the patient.
Limited information on how physicians weigh in different factors when making therapeutic
decisions.
Physicians (cognitive biases affecting decision making) and health system (e.g. access to an
infusion center) factors are the most responsible causes of practice gaps in MS care. The
physician's component is the least studied.
Therapeutic inertia (TI) is a common phenomenon in MS care defined as lack of treatment
initiation or escalation (e.g. switch interferons or glatiramer to fingolimod /alemtuzumab
/natalizumab/ocrelizumab/ etc.) when recommended by guidelines or evidence of disease
progression. This phenomenon leads to poorer patient's outcomes, greater disability, and
diminished quality of life.
Goals of the study: i) to determine what are the most relevant factors influencing
therapeutic decisions among neurologists with expertise in MS care; ii) to asses whether
physicians rely on medical information provided in a case scenario versus a quantitative or
qualitative estimation of disease progression based on hypothetical models.
;
Status | Clinical Trial | Phase | |
---|---|---|---|
Completed |
NCT05528666 -
Risk Perception in Multiple Sclerosis
|
||
Completed |
NCT03608527 -
Adaptive Plasticity Following Rehabilitation in Multiple Sclerosis
|
N/A | |
Recruiting |
NCT05532943 -
Evaluate the Safety and Efficacy of Allogeneic Umbilical Cord Mesenchymal Stem Cells in Patients With Multiple Sclerosis
|
Phase 1/Phase 2 | |
Completed |
NCT02486640 -
Evaluation of Potential Predictors of Adherence by Investigating a Representative Cohort of Multiple Sclerosis (MS) Patients in Germany Treated With Betaferon
|
||
Completed |
NCT01324232 -
Safety and Efficacy of AVP-923 in the Treatment of Central Neuropathic Pain in Multiple Sclerosis
|
Phase 2 | |
Completed |
NCT04546698 -
5-HT7 Receptor Implication in Inflammatory Mechanisms in Multiple Sclerosis
|
||
Active, not recruiting |
NCT04380220 -
Coagulation/Complement Activation and Cerebral Hypoperfusion in Relapsing-remitting Multiple Sclerosis
|
||
Completed |
NCT02835677 -
Integrating Caregiver Support Into MS Care
|
N/A | |
Completed |
NCT03686826 -
Feasibility and Reliability of Multimodal Evoked Potentials
|
||
Recruiting |
NCT05964829 -
Impact of the Cionic Neural Sleeve on Mobility in Multiple Sclerosis
|
N/A | |
Withdrawn |
NCT06021561 -
Orofacial Pain in Multiple Sclerosis
|
||
Completed |
NCT03653585 -
Cortical Lesions in Patients With Multiple Sclerosis
|
||
Recruiting |
NCT04798651 -
Pathogenicity of B and CD4 T Cell Subsets in Multiple Sclerosis
|
N/A | |
Active, not recruiting |
NCT05054140 -
Study to Evaluate Efficacy, Safety, and Tolerability of IMU-838 in Patients With Progressive Multiple Sclerosis
|
Phase 2 | |
Completed |
NCT05447143 -
Effect of Home Exercise Program on Various Parameters in Patients With Multiple Sclerosis
|
N/A | |
Recruiting |
NCT06195644 -
Effect of Galvanic Vestibular Stimulation on Cortical Excitability and Hand Dexterity in Multiple Sclerosis Patients
|
Phase 1 | |
Completed |
NCT04147052 -
iSLEEPms: An Internet-Delivered Intervention for Sleep Disturbance in Multiple Sclerosis
|
N/A | |
Completed |
NCT03594357 -
Cognitive Functions in Patients With Multiple Sclerosis
|
||
Completed |
NCT03591809 -
Combined Exercise Training in Patients With Multiple Sclerosis
|
N/A | |
Completed |
NCT02845635 -
MS Mosaic: A Longitudinal Research Study on Multiple Sclerosis
|