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多发性硬化症患者CCSVI治疗的医疗旅游:一项观察性研究。

Medical Tourism for CCSVI Procedures in People with Multiple Sclerosis: An Observational Study.

作者信息

Metz Luanne M, Greenfield Jamie, Marrie Ruth Ann, Jette Nathalie, Blevins Gregg, Svenson Lawrence W, Alikhani Katayoun, Wall Winona, Dhaliwal Raveena, Suchowersky Oksana

机构信息

1Department of Clinical Neurosciences,University of Calgary,Calgary,Alberta,Canada.

3Departments of Internal Medicine and Community Health Sciences,University of Manitoba,Winnipeg,Manitoba,Canada.

出版信息

Can J Neurol Sci. 2016 May;43(3):360-7. doi: 10.1017/cjn.2015.350. Epub 2016 Feb 4.


DOI:10.1017/cjn.2015.350
PMID:26891024
Abstract

BACKGROUND: Many Canadians with multiple sclerosis (MS) have recently travelled internationally to have procedures for a putative condition called chronic cerebrospinal venous insufficiency (CCSVI). Here, we describe where and when they went and describe the baseline characteristics of persons with MS who participated in this non-evidence-based medical tourism for CCSVI procedures. METHODS: We conducted a longitudinal observational study that used online questionnaires to collect patient-reported information about the safety, experiences, and outcomes following procedures for CCSVI. A convenience sample of all Albertans with MS was recruited between July 2011 and March 2013. RESULTS: In total, 868 individuals enrolled; 704 were included in this cross-sectional, baseline analysis. Of these, 128 (18.2%) participants retrospectively reported having procedures for CCSVI between April 2010 and September 2012. The proportion of participants reporting CCSVI procedures declined from 80 (62.5%) in 2010, to 40 (31.1%) in 2011, and 8 (6.3%) in 2012. In multivariable logistic regression analysis, CCSVI procedures were independently associated with longer disease duration, secondary progressive clinical course, and greater disability status. CONCLUSIONS: Although all types of people with MS pursued procedures for CCSVI, a major driver of participation was greater disability. This highlights that those with the greatest disability are the most vulnerable to unproven experimental procedures. Participation in CCSVI procedures waned over time possibly reflecting unmet expectations of treated patients, decreased media attention, or that individuals who wanted procedures had them soon after the CCSVI hypothesis was widely publicized.

摘要

背景:许多患有多发性硬化症(MS)的加拿大人最近前往国外,接受一种被称为慢性脑脊髓静脉功能不全(CCSVI)的假定病症的治疗。在此,我们描述他们前往的地点和时间,并描述参与这种基于非循证医学的CCSVI治疗的MS患者的基线特征。 方法:我们进行了一项纵向观察性研究,使用在线问卷收集患者报告的关于CCSVI治疗后的安全性、体验和结果的信息。在2011年7月至2013年3月期间,招募了艾伯塔省所有MS患者的便利样本。 结果:共有868人登记;704人纳入本次横断面基线分析。其中,128名(18.2%)参与者回顾性报告在2010年4月至2012年9月期间接受了CCSVI治疗。报告接受CCSVI治疗的参与者比例从2010年的80人(62.5%)降至2011年的40人(31.1%),2012年为8人(6.3%)。在多变量逻辑回归分析中,CCSVI治疗与疾病持续时间较长、继发进展性临床病程和残疾程度较高独立相关。 结论:尽管所有类型的MS患者都寻求CCSVI治疗,但参与的一个主要驱动因素是残疾程度较高。这突出表明,残疾程度最高的人最容易受到未经证实的实验性治疗的影响。随着时间的推移,参与CCSVI治疗的人数逐渐减少,这可能反映了接受治疗患者的期望未得到满足、媒体关注度下降,或者是那些想要接受治疗的人在CCSVI假说被广泛宣传后不久就接受了治疗。

相似文献

[1]
Medical Tourism for CCSVI Procedures in People with Multiple Sclerosis: An Observational Study.

Can J Neurol Sci. 2016-5

[2]
Proposed chronic cerebrospinal venous insufficiency criteria do not predict multiple sclerosis risk or severity.

Ann Neurol. 2011-7

[3]
"I knew what was going to happen if I did nothing and so I was going to do something": faith, hope, and trust in the decisions of Canadians with multiple sclerosis to seek unproven interventions abroad.

BMC Health Serv Res. 2014-9-30

[4]
Percutaneous transluminal angioplasty for treatment of chronic cerebrospinal venous insufficiency (CCSVI) in multiple sclerosis patients.

Cochrane Database Syst Rev. 2012-12-12

[5]
Chronic cerebrospinal venous insufficiency is not associated with multiple sclerosis and its severity: a blind-verified study.

PLoS One. 2013-2-13

[6]
Progressive multiple sclerosis is not associated with chronic cerebrospinal venous insufficiency.

Neurology. 2011-8-17

[7]
A prospective open-label study of endovascular treatment of chronic cerebrospinal venous insufficiency.

J Vasc Surg. 2009-12

[8]
"Liberation treatment" for chronic cerebrospinal venous insufficiency in multiple sclerosis: the truth will set you free.

Brain Behav. 2015-1

[9]
Brain hemodynamic changes associated with chronic cerebrospinal venous insufficiency are not specific to multiple sclerosis and do not increase its severity.

Radiology. 2012-8-21

[10]
Chronic cerebrospinal venous insufficiency is not associated with cognitive impairment in multiple sclerosis.

BMC Med. 2013-7-18

引用本文的文献

[1]
Self-Reported Diet and Health Outcomes of Participants of the CCSVI-Tracking Survey Study.

Nutrients. 2021-5-31

[2]
Effects of Psychiatric Comorbidity in Immune-Mediated Inflammatory Disease: Protocol for a Prospective Study.

JMIR Res Protoc. 2018-1-17

[3]
Discriminative ability of quality of life measures in multiple sclerosis.

Health Qual Life Outcomes. 2017-12-21

[4]
Caught in a no-win situation: discussions about CCSVI between persons with multiple sclerosis and their neurologists - a qualitative study.

BMC Neurol. 2017-9-7

[5]
Trade-Offs: Pros and Cons of Being a Doctor and Patient in Canada.

J Gen Intern Med. 2017-5

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