dc.contributor.author	Kingwell, Elaine
dc.contributor.author	Marriott, James J
dc.contributor.author	Jetté, Nathalie
dc.contributor.author	Pringsheim, Tamara
dc.contributor.author	Makhani, Naila
dc.contributor.author	Morrow, Sarah A
dc.contributor.author	Fisk, John D
dc.contributor.author	Evans, Charity
dc.contributor.author	Béland, Sarah G
dc.contributor.author	Kulaga, Sophie
dc.contributor.author	Dykeman, Jonathan
dc.contributor.author	Wolfson, Christina
dc.contributor.author	Koch, Marcus W
dc.contributor.author	Marrie, Ruth A
dc.date.accessioned	2013-10-22T23:02:55Z
dc.date.available	2013-10-22T23:02:55Z
dc.date.issued	2013-09-26
dc.date.updated	2013-10-22T23:02:56Z
dc.description.abstract	Abstract Background Multiple sclerosis (MS) is the most common cause of neurological disability in young adults worldwide and approximately half of those affected are in Europe. The assessment of differential incidence and prevalence across populations can reveal spatial, temporal and demographic patterns which are important for identifying genetic and environmental factors contributing to MS. However, study methodologies vary and the quality of the methods can influence the estimates. This study aimed to systematically review European studies of incidence and prevalence of MS and to provide a quantitative assessment of their methodological quality. Methods A comprehensive literature search was performed to obtain all original population-based studies of MS incidence and prevalence in European populations conducted and published between January 1985 and January 2011. Only peer-reviewed full-text articles published in English or French were included. All abstracts were screened for eligibility and two trained reviewers abstracted the data and graded the quality of each study using a tool specifically designed for this study. Results There were 123 studies that met the inclusion criteria. The study estimates were highly heterogeneous, even within regions or countries. Quality was generally higher in the more recent studies, which also tended to use current diagnostic criteria. Prevalence and incidence estimates tended to be higher in the more recent studies and were higher in the Nordic countries and in northern regions of the British Isles. With rare exceptions, prevalence and incidence estimates were higher in women with ratios as high as 3:1. Few studies examined ethnicity. Epidemiological data at the national level was uncommon and there were marked geographical disparities in available data, with large areas of Europe unrepresented and other regions well-represented in the literature. Only 37% of the studies provided standardized estimates. Conclusions Despite the breadth of the literature on the epidemiology of MS in Europe, inter-study comparisons are hampered by the lack of standardization. Further research should focus on regions not yet studied and the evaluation of ethnic differences in MS prevalence and incidence. National-level studies using current diagnostic criteria, validated case definitions and similar age- and sex-standardization would allow better geographical comparisons.
dc.description.version	Peer Reviewed
dc.identifier.citation	BMC Neurology. 2013 Sep 26;13(1):128
dc.identifier.doi	http://dx.doi.org/10.1186/1471-2377-13-128
dc.identifier.uri	http://hdl.handle.net/1993/22239
dc.language.rfc3066	en
dc.rights	open access	en_US
dc.rights.holder	Elaine Kingwell et al.; licensee BioMed Central Ltd.
dc.title	Incidence and prevalence of multiple sclerosis in Europe: a systematic review
dc.type	Journal Article

Incidence and prevalence of multiple sclerosis in Europe: a systematic review

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