Journal article
The benefit of evolving multidisciplinary care in ALS: a diagnostic cohort survival comparison
- Abstract:
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Background Care for people with amyotrophic lateral sclerosis (ALS) has altered at the King’s College Hospital over the last 20 years. The clinic has been a multidisciplinary, specialist, tertiary referral centre since 1995 with a large team with integrated palliative and respiratory care since 2006. We hypothesized that these changes would improve survival.
Methods In this retrospective observational study, patients diagnosed with El Escorial definite, probable and possible ALS between 1995-1998 and 2008-2011 were followed up. The primary outcome measure was a chi-squared test for the proportion of each cohort surviving. Kaplan-Meier survival analysis and Cox multivariate regression were secondary analyses.
Results There was low reporting of some interventions. 547 people were included. Survival between the cohorts was significantly different (p = 0.022) with a higher proportion surviving during 2008-2011. Survival time was 21.6 (95% CI 19.2- 24.0) months in the 2008-2011 cohort compared to the 19.2 (15.6- 21.6) in the 1995-1998 cohort (log rank p = 0.018). 493 cases were included in the Cox regression. Diagnostic cohort was a significant predictor variable (HR 0.79 (0.64-0.97) p = 0.023).
Conclusions These results support the hypothesis that integrated specialist clinics, with multidisciplinary input improve survival in ALS.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 1.2MB, Terms of use)
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- Publisher copy:
- 10.1080/21678421.2017.1349151
Authors
- Publisher:
- Taylor and Francis
- Journal:
- Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration More from this journal
- Volume:
- 18
- Issue:
- 7-8
- Pages:
- 569-575
- Publication date:
- 2017-07-18
- Acceptance date:
- 2017-06-20
- DOI:
- EISSN:
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2167-9223
- ISSN:
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2167-8421
- Keywords:
- Pubs id:
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pubs:702103
- UUID:
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uuid:cb93062f-1540-4fc0-be68-cb7aebeb47f7
- Local pid:
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pubs:702103
- Source identifiers:
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702103
- Deposit date:
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2017-06-29
Terms of use
- Copyright holder:
- © 2017 Martin, et al Published by Informa UK Limited, trading as Taylor and Francis Group
- Copyright date:
- 2017
- Notes:
- This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.
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