Optimization of treatment with interferon beta in multiple sclerosis. Usefulness of automatic system application criteria

Background. A software based tool has been developed (Optem) to allow automatize the recommendations of the Canadian Multiple Sclerosis Working Group for optimizing MS treatment in order to avoid subjective interpretation. METHODS: Treatment Optimization Recommendations (TORs) were applied to our database of patients treated with IFN beta1a IM. Patient data were assessed during year 1 for disease activity, and patients were assigned to 2 groups according to TOR: "change treatment" (CH) and "no change treatment" (NCH). These assessments were then compared to observed clinical outcomes for disease activity over the following years. RESULTS: We have data on 55 patients. The "change treatment" status was assigned to 22 patients, and "no change treatment" to 33 patients. The estimated sensitivity and specificity according to last visit status were 73.9% and 84.4%. During the following years, the Relapse Rate was always higher in the "change treatment" group than in the "no change treatment" group (5 y; CH: 0.7, NCH: 0.07; p < 0.001, 12 m - last visit; CH: 0.536, NCH: 0.34). We obtained the same results with the EDSS (4 y; CH: 3.53, NCH: 2.55, annual progression rate in 12 m - last visit; CH: 0.29, NCH: 0.13). CONCLUSION: Applying TOR at the first year of therapy allowed accurate prediction of continued disease activity in relapses and disability progression.

Andalusian Health Repository: Promoting the scientific health output among professionals and providing citizens with quality health information

The Andalusian Public Health System (Sistema Sanitario Público de Andalucía -SSPA) Repository is the open environment where all the scientific output generated by the SSPA professionals, resulting from their medical care, research and administrative activities, is comprehensively collected and managed. This repository possesses special features which determined its development: the SSPA organization and its purpose as a health institution, the specific sets of documents that it generates and the stakeholders involved in it. The repository uses DSpace 1.6.2, to which several changes were implemented in order to achieve the SSPA initial goals and requirements. The main changes were: the addition of specific qualifiers to the Metadata Dublin Core scheme, the modification of the submission form, the integration of the MeSH Thesaurus as controlled vocabulary and the optimization of the advanced search tool. Another key point during the setting up of the repository was the initial batch ingest of the documents.