AAN Emphasizes Patient Perspective, Transparency in MS Guideline Development


Lead author Alexander D. Rae-Grant, MD, explains the measures taken to ensure the panel got their 16-year multiple sclerosis recommendations update right.

The American Academy of Neurology (AAN) panel behind the implementation of 30 updated recommendations for multiple sclerosis (MS) disease-modifying therapy (DMT) from its most recent in 2002 did enough preliminary work to ensure there would be limited follow-up work.

In an interview with MD Magazine hours after the new recommendations were announced at the 70th annual AAN meeting in Los Angeles, lead author Alexander D. Rae-Grant, MD, of Cleveland Clinic in Cleveland, Ohio, and a Fellow of AAN, detailed the intricacies of designing comprehensive guidelines.

The panel that undertook the task followed guideline development recommendations from the Institute of Medicine, Rae-Grant said. They also hosted 2 series of public review, withheld panelists with any conflicts of interests to be involved in the systematic review process, actively sought out comment review from peers, and made what Rae-Grant believes to be an earnest effort to practice transparency on any conflicting opinions.

“The process was very robust, and allowed us to make, I think, the best recommendations we could do with the evidence available,” Rae-Grant said.

These new guidelines also benefitted from the input of patients with MS, as panelists with the condition helped lead rhetoric surrounding care issues from the very start, Rae-Grant said.

“All through this process they were kind of an important in what we did and what we delivered. I certainly want to emphasize that was very important — and a new thing,” Rae-Grant said.

The end result was a series of guidelines with limited instances of non-consensus recommendations and a reformed perspective on managing DMT care in a field with newer breakthrough therapies.

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For more extensive coverage pertaining to multiple sclerosis, check out MD Magazine's sister site, NeurologyLive. The Clinical Focus page serves as a resource for articles, videos, and newly released data from the field’s most attended conferences.

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