MS Practice Profiles: Clinical-Pathological Disconnect

Sponsored by the Postgraduate Institute for Medicine

Release date: July 2007
Expiration date: July 2008
Estimated time to complete activity: 15 Minutes
This educational program is supported through an educational grant from Biogen IDEC and Elan Pharmaceuticals Inc.

Program Overview

MRI offers by far the most sensitive technique for detecting multiple sclerosis lesions and has proved to be an important paraclinical tool for diagnosing MS and monitoring therapeutic trials. Neurodegeneration is increasingly being recognized as an important factor in the pathogenesis of MS, and MRI measures of brain atrophy have been suggested as surrogate markers of neuroaxonal loss and disease progression. This case-based presentation will look at the clinical challenges of a patient who presents in disease remission but who has a progressively worsening picture on MRI.

Target Audience

This activity has been designed to meet the educational needs of neurologists, physicians and nurses involved in the management of patients with multiple sclerosis.

Learning Objectives

Upon completion of this activity, the participant will be able to:

Program Co-Chairs:

Robert J. Fox, MD
Staff Neurologist
The Cleveland Clinic
Cleveland, Ohio

Robert J. Fox, MD, is a staff neurologist at the Cleveland Clinic Foundation in Ohio. He is also the director of the Mellen Center MS tissue donation program.

Dr. Fox received his undergraduate degree from Amherst College and his medical degree from Johns Hopkins University. He pursued residency training in neurology at the Hospital of the University of Pennsylvania in Philadelphia. Dr. Fox completed clinical training as a Potiker Fellow at the Mellen Center for Multiple Sclerosis Treatment and Research at the Cleveland Clinic Foundation.

Nilay Shah, MD
Director, Neurology Division
Riverfront Medical Associates
Edgewater, NJ

Nilay Shah, MD, is in private practice in the metro New York area. He also teaches neurology as an assistant professor in neurology at St. George's University School of Medicine. He previously had a private practice in upstate New York, and ran a clinic for patients with multiple sclerosis about 60 miles northwest of New York City for nearly three years.

Dr. Shah is a founding member and director of communications for the New York State Neurological Society, and also sits on the advisory board for the MS Society of Southern New York State. His other interests include the use of technology in healthcare, and he's given a number of lectures at medical society meetings around the country as co-founder and CIO of MedicalPocketPC.com, a website for healthcare professionals using handheld technology to improve patient care.

After getting his undergraduate degree at Cornell University and finishing medical school at St. George's University, Dr. Shah went on to a Neurology Residency at Mt. Sinai Medical Center. He completed a Neurophysiology Fellowship at the University of Pittsburgh.

Author:
J. Theodore Phillips, MD, PhD
Clinical Professor of Neurology
University of Texas Southwestern Medical Center
Dallas, Texas

J. Theodore Phillips, MD, PhD, is a faculty member of the multiple sclerosis comprehensive treatment training program at University of Texas Southwestern Medical Center. He has served for many years on the clinical advisory committee of the Lone Star MS chapter and additionally is a member of the national medical advisory board of the National MS Society. Dr. Phillips has served as director of the MS Center at UT Southwestern, and has been director of the MS Clinical and Research Center at Texas Neurology in Dallas since 1993.

A frequent lecturer to professional and patient groups, Dr. Phillips has authored or co-authored numerous peer-reviewed publications in neurology and immunology relating to multiple sclerosis. Dr. Phillips has been selected among the "Best Doctors in Dallas" by D Magazine, Dallas, "Best Doctors in Texas" by Texas Monthly and "Best Doctors in America."

Dr. Phillips graduated with honors from the University of Texas at Austin and subsequently received MD and PhD (Immunology) degrees from the University of Texas Southwestern Medical Center.

Instructions for Credit

Physician Continuing Education
Accreditation Statement

This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Postgraduate Institute for Medicine (PIM) and Healthology, Inc. PIM is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation
The Postgraduate Institute for Medicine designates this educational activity for a maximum of 0.25 AMA PRA Category 1 Credit(s). Physicians should only claim credit commensurate with the extent of their participation in the activity.

California Board of Registered Nursing
Postgraduate Institute for Medicine is approved by the California Board of Registered Nursing, Provider Number 13485 for 0.25 contact hours.

Fee Information
There is no fee for this educational activity.

Disclosure of Conflicts of Interest
The Postgraduate Institute for Medicine (PIM) assesses conflict of interest with its instructors, planners, managers, and other individuals who are in a position to control the content of CME activities. All relevant conflicts of interest that are identified are thoroughly vetted by PIM for fair balance, scientific objectivity of studies utilized in this activity, and patient care recommendations. PIM is committed to providing its learners with high-quality CME activities and related materials that promote improvements of quality in healthcare and not a specific proprietary business interest of a commercial interest.

The following faculty reported a real or apparent conflict of interest:

Robert J. Fox, MD (Co-Chair) Type of financial relationship: Consultant Grants/Research Support and Honorarium for; Genentech, Merck, Biogen IDEC, Questcor and TevaNeuroscience

J. Theodore Phillips, MD, PhD Type of financial relationship: Consultant Fees: Biogen Idec & Elan Pharmaceuticals

Nilay Shah, MD (Co-Chair): Has no relevant information to disclose.

The following planners and managers reported a real or apparent conflict of interest:

Carol A. Smyth, MB BCh BAO (Healthology) No financial interest/relationships relating to the topic of this activity.

Jan Hixon, RN, BSN, MA (PIM) No financial interest/relationships relating to the topic of this activity.

Method of Participation

There are no fees for participating and receiving CME credit for this activity. During the period July 26, 2007, through July 26, 2008, participants must: 1) read the learning objectives and faculty disclosures; 2) study the educational activity; 3) complete the post-test by recording the best answer to each question in the answer key on the evaluation form; and 4) complete the evaluation form.

A statement of credit will be issued only upon receipt of a completed activity evaluation form and a completed post-test with a score of 70 percent or better. Your statement of credit will be mailed to you within three weeks.

Media

Internet

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The Postgraduate Institute for Medicine (PIM), Healthology Inc., and Biogen IDEC and Elan Pharmaceuticals Inc. do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of PIM, Healthology Inc., and Biogen IDEC and Elan Pharmaceuticals Inc. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient's conditions and possible contraindications on dangers in use, review of any applicable manufacturer's product information, and comparison with recommendations of other authorities.

Produced by Healthology Inc. © 2007

Sponsored by the Postgraduate Institute for Medicine
Supported through an educational grant from Biogen IDEC and Elan Pharmaceuticals Inc.