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      Prevalence of multiple sclerosis in Croatia: data from national and non-governmental organization registries

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          To update the estimate of multiple sclerosis (MS) prevalence in Croatia using multiple epidemiological tools.


          This level IV, epidemiological study gathered data from three national patient registries and one database of a non-governmental MS patients' organization. Data were extracted on all individuals who had undergone hospital MS treatment, consulted their primary health care providers about MS-related symptoms, been listed as having MS-related disability, or been members of the mentioned non-governmental organization in 2015. A new database was formed, in which all living individuals were identified using a common identification number to prevent double entries. The prevalence rates in 2015 were calculated by age and sex groups.


          In total, 6160 patients diagnosed with MS were identified (72% women). Most women with MS were 50-59 years old and most men were 40-49 years old. The overall MS prevalence rate was 143.8 per 100 000 population.


          The calculated MS prevalence rate in Croatia in 2015 was more than twice as high as the estimate from 2013. This difference warrants further research into MS epidemiology in Croatia and calls for a rational allocation of funds and human resources to provide adequate care and support to MS patients.

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          Most cited references 7

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          The cost burden of multiple sclerosis in the United States: a systematic review of the literature.

          To estimate average annual cost per multiple sclerosis (MS) patient in the US using published estimates from the literature.
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            Cost of Illness of Multiple Sclerosis - A Systematic Review

            Background Cost-of-illness (COI) studies of Multiple Sclerosis (MS) are vital components for describing the economic burden of MS, and are frequently used in model studies of interventions of MS. We conducted a systematic review of studies estimating the COI of MS, to compare costs between studies and examine cost drivers, emphasizing generalizability and methodological choices. Material and method A literature search on studies published in English on COI of MS was performed in PubMed for the period January 1969 to January 2014, resulting in 1,326 publications. A mapping of studies using a bottom-up approach or top-down approach, respectively, was conducted for the 48 studies assessed as relevant. In a second analysis, the cost estimates were compared between the 29 studies that used a societal perspective on costs, human capital approach for indirect costs, presenting number of patients included, time-period studied, and year of price level used. Results The mapping showed that bottom-up studies and prevalence approaches were most common. The cost ratios between different severity levels within studies were relatively stable, to the ratio of 1 to 2 to 3 for disability level categories. Drugs were the main cost drivers for MS-patients with low disease severity, representing 29% to 82% of all costs in this patient group, while the main cost components for groups with more advanced MS symptoms were production losses due to MS and informal care, together representing 17% to 67% of costs in those groups. Conclusion The bottom-up method and prevalence approach dominated in studies of COI of MS. Our findings show that there are difficulties in comparing absolute costs across studies, nevertheless, the relative costs expressed as cost ratios, comparing different severity levels, showed higher resemblance. Costs of drugs were main cost drivers for less severe MS and informal care and production losses for the most severe MS.
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              Accuracy of data in computer-based patient records.

               W Hogan,  M M Wagner (2015)
              Data in computer-based patient records (CPRs) have many uses beyond their primary role in patient care, including research and health-system management. Although the accuracy of CPR data directly affects these applications, there has been only sporadic interest in, and no previous review of, data accuracy in CPRs. This paper reviews the published studies of data accuracy in CPRs. These studies report highly variable levels of accuracy. This variability stems from differences in study design, in types of data studied, and in the CPRs themselves. These differences confound interpretation of this literature. We conclude that our knowledge of data accuracy in CPRs is not commensurate with its importance and further studies are needed. We propose methodological guidelines for studying accuracy that address shortcomings of the current literature. As CPR data are used increasingly for research, methods used in research databases to continuously monitor and improve accuracy should be applied to CPRs.

                Author and article information

                Croat Med J
                Croat. Med. J
                Croatian Medical Journal
                Croatian Medical Schools
                April 2018
                : 59
                : 2
                : 65-70
                [1 ]Division for Public Health, Croatian Institute of Public Health, Zagreb, Croatia
                [2 ]Alliance of Croatian Multiple Sclerosis Associations, Zagreb, Croatia
                [3 ]Department of Neurology, University Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
                [4 ]Department of Social Medicine and Epidemiology, University of Rijeka School of Medicine, Rijeka, Croatia
                Author notes
                Correspondence to:
Tomislav Benjak
Division for Public Health 
Croatian Institute of Public Health
Rockefellerova ulica 7
10000 Zagreb, Croatia 
                Copyright © 2018 by the Croatian Medical Journal. All rights reserved.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Public Health



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