{"id":{"repo_id":"ohiolink","oai_identifier":"oai:etd.ohiolink.edu:case1355951207"},"canonical_url":"https://search.dev.ndltd.org/etd/ohiolink/oai:etd.ohiolink.edu:case1355951207","repository":{"repo_id":"ohiolink","name":"OhioLINK","base_url":"https://etd.ohiolink.edu/acprod/odb_etd/ws/oai/oai"},"display":{"title":"Impact of Race on Use of Disease-Modifying Therapy in Multiple Sclerosis","abstract":"<b>Introduction:</b> Multiple sclerosis (MS) has been shown to take a more aggressive course in African American (AA) patients as compared with Caucasians. Disease modifying therapy (DMT) decreases the rate of relapses in MS, and racial differences in the use of DMT could contribute to differences in disability.<b>Methods:</b> The Knowledge Program (KP), a Cleveland Clinic electronic database linked to the Epic electronic medical record, was queried for patients aged 18-65, Caucasian or AA, with MS or clinically isolated syndrome (CIS) in whom treatment status was known. Propensity scores for likelihood of being on DMT were calculated based on multiple clinical characteristics. Subclassification and matching techniques were applied using the propensity scores, and odds ratios were calculated to determine odds of racial background between the treated and untreated patients.<b>Results:</b> A total of 4630 patients were analyzed. No significant difference in race was identified between treated and untreated patients with similar probability of being on a DMT.<b>Discussion:</b> Although compliance with treatment and other factors may play a role in the worse disability outcomes in AA patients, patient and clinician utilization of DMT prescription does not appear to play a significant role.","abstract_html":"&lt;b&gt;Introduction:&lt;/b&gt; Multiple sclerosis (MS) has been shown to take a more aggressive course in African American (AA) patients as compared with Caucasians. Disease modifying therapy (DMT) decreases the rate of relapses in MS, and racial differences in the use of DMT could contribute to differences in disability.&lt;b&gt;Methods:&lt;/b&gt; The Knowledge Program (KP), a Cleveland Clinic electronic database linked to the Epic electronic medical record, was queried for patients aged 18-65, Caucasian or AA, with MS or clinically isolated syndrome (CIS) in whom treatment status was known. Propensity scores for likelihood of being on DMT were calculated based on multiple clinical characteristics. Subclassification and matching techniques were applied using the propensity scores, and odds ratios were calculated to determine odds of racial background between the treated and untreated patients.&lt;b&gt;Results:&lt;/b&gt; A total of 4630 patients were analyzed. No significant difference in race was identified between treated and untreated patients with similar probability of being on a DMT.&lt;b&gt;Discussion:&lt;/b&gt; Although compliance with treatment and other factors may play a role in the worse disability outcomes in AA patients, patient and clinician utilization of DMT prescription does not appear to play a significant role.","abstract_has_math":false,"creators":["Hyland, Megan H."],"institution":"Case Western Reserve University School of Graduate Studies","degree_name":"Master of Sciences","degree_level":"masters","degree_discipline":"Clinical Research","degree_department":null,"school":null,"contributors":["Cohen, Jeffrey","Love, Thomas"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2013,"date_issued":"2013-03-08","date_published":"2013-03-08","updated_at":"2026-07-24T03:35:52Z","subjects":["Medicine","Neurology","Multiple sclerosis","Treatment","Race"],"languages":["English"],"rights":["unrestricted","This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws."],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"http://rave.ohiolink.edu/etdc/view?acc_num=case1355951207","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Cohen, Jeffrey","Love, Thomas"]},{"key":"dc:creator","label":"Author","values":["Hyland, Megan H."]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date","label":"Dc Date","values":["2013-03-08"]},{"key":"dc:publisher","label":"Institution","values":["Case Western Reserve University School of Graduate Studies / OhioLINK"]},{"key":"dc:type","label":"Dc Type","values":["Electronic Thesis or Dissertation"]},{"key":"thesis:degree_discipline","label":"Discipline","values":["Clinical Research"]},{"key":"thesis:degree_level","label":"Degree Level","values":["masters"]},{"key":"thesis:degree_name","label":"Degree Name","values":["Master of Sciences"]},{"key":"thesis:institution_name","label":"Thesis Institution Name","values":["Case Western Reserve University School of Graduate Studies"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Medicine","Neurology","Multiple sclerosis","Treatment","Race"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language","label":"Dc Language","values":["English"]},{"key":"dc:rights","label":"Dc Rights","values":["unrestricted","This thesis or dissertation is protected by copyright: all rights reserved. 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Propensity scores for likelihood of being on DMT were calculated based on multiple clinical characteristics. Subclassification and matching techniques were applied using the propensity scores, and odds ratios were calculated to determine odds of racial background between the treated and untreated patients.<b>Results:</b> A total of 4630 patients were analyzed. No significant difference in race was identified between treated and untreated patients with similar probability of being on a DMT.<b>Discussion:</b> Although compliance with treatment and other factors may play a role in the worse disability outcomes in AA patients, patient and clinician utilization of DMT prescription does not appear to play a significant role."]},{"key":"dc:format","label":"Dc Format","values":["application/pdf","p.47","1.96 MB"]},{"key":"dc:title","label":"Title","values":["Impact of Race on Use of Disease-Modifying Therapy in Multiple Sclerosis"]}]}],"canonical_facts":{"dc:contributor":["Cohen, Jeffrey","Love, Thomas"],"dc:creator":["Hyland, Megan H."],"dc:date":["2013-03-08"],"dc:description":["<b>Introduction:</b> Multiple sclerosis (MS) has been shown to take a more aggressive course in African American (AA) patients as compared with Caucasians. Disease modifying therapy (DMT) decreases the rate of relapses in MS, and racial differences in the use of DMT could contribute to differences in disability.<b>Methods:</b> The Knowledge Program (KP), a Cleveland Clinic electronic database linked to the Epic electronic medical record, was queried for patients aged 18-65, Caucasian or AA, with MS or clinically isolated syndrome (CIS) in whom treatment status was known. Propensity scores for likelihood of being on DMT were calculated based on multiple clinical characteristics. Subclassification and matching techniques were applied using the propensity scores, and odds ratios were calculated to determine odds of racial background between the treated and untreated patients.<b>Results:</b> A total of 4630 patients were analyzed. No significant difference in race was identified between treated and untreated patients with similar probability of being on a DMT.<b>Discussion:</b> Although compliance with treatment and other factors may play a role in the worse disability outcomes in AA patients, patient and clinician utilization of DMT prescription does not appear to play a significant role."],"dc:format":["application/pdf","p.47","1.96 MB"],"dc:identifier":["http://rave.ohiolink.edu/etdc/view?acc_num=case1355951207"],"dc:language":["English"],"dc:publisher":["Case Western Reserve University School of Graduate Studies / OhioLINK"],"dc:rights":["unrestricted","This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws."],"dc:subject":["Medicine","Neurology","Multiple sclerosis","Treatment","Race"],"dc:title":["Impact of Race on Use of Disease-Modifying Therapy in Multiple Sclerosis"],"dc:type":["Electronic Thesis or Dissertation"],"thesis:degree_discipline":["Clinical Research"],"thesis:degree_level":["masters"],"thesis:degree_name":["Master of Sciences"],"thesis:institution_name":["Case Western Reserve University School of Graduate Studies"]},"updated_at":"2026-07-24T03:35:52Z"}