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March 05, 2019; 92 (10) ArticleOpen Access

Validation of an algorithm for identifying MS cases in administrative health claims datasets

William J. Culpepper, Ruth Ann Marrie, Annette Langer-Gould, Mitchell T. Wallin, Jonathan D. Campbell, Lorene M. Nelson, Wendy E. Kaye, Laurie Wagner, Helen Tremlett, Lie H. Chen, Stella Leung, Charity Evans, Shenzhen Yao, Nicholas G. LaRocca, on behalf of the United States Multiple Sclerosis Prevalence Workgroup (MSPWG)
First published February 15, 2019, DOI: https://doi.org/10.1212/WNL.0000000000007043
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Article Information

vol. 92 no. 10 e1016-e1028
DOI: 
https://doi.org/10.1212/WNL.0000000000007043
PubMed: 
30770432
Published By: 
Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology
Print ISSN: 
0028-3878
Online ISSN: 
1526-632X
History: 
  • Received July 20, 2018
  • Accepted in final form November 24, 2018
  • First Published February 15, 2019.

Article Versions

Copyright & Usage: 
Copyright © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND), which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Author Disclosures

    1. William J. Culpepper, PhD, MA,
    2. Ruth Ann Marrie, MD, PhD,
    3. Annette Langer-Gould, MD, PhD,
    4. Mitchell T. Wallin, MD, MPH,
    5. Jonathan D. Campbell, PhD,
    6. Lorene M. Nelson, PhD,
    7. Wendy E. Kaye, PhD,
    8. Laurie Wagner, MPH,
    9. Helen Tremlett, PhD,
    10. Lie H. Chen, DrPH,
    11. Stella Leung, MSc,
    12. Charity Evans, PhD,
    13. Shenzhen Yao, MD, MSc,
    14. Nicholas G. LaRocca, PhD;
    15. on behalf of the United States Multiple Sclerosis Prevalence Workgroup (MSPWG)
  1. William J. Culpepper, PhD, MA,
    2. Scientific Advisory Boards:

    1. National MS Prevalence Work Group, National MS Society

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NONE

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  2. Ruth Ann Marrie, MD, PhD,
    3. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. Neurology, Editorial BoardMultiple Sclerosis Journal, Editorial Board

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. Received support as principal investigator from theCanadian Institutes of Health Research (2010-2019), and Research Manitoba (2014-2019).Public Health Agency of Canada,Health Sciences Centre Foundation

    Research Support, Academic Entities:

    1. Waugh Family Chair in Multiple Sclerosis

    Research Support, Foundations and Societies:

    1. Received support as principal investigator from Multiple Sclerosis Society of Canada (2009-2016) and theNational Multiple Sclerosis Society (2013-2017), and as co-principal investigator from Multiple Sclerosis Scientific Foundation (2009-2018). Received support from Consortium of Multiple Sclerosis Centers (2004-2009, 2011-2014, 2016-2017), Crohn's and Colitis Canada (2014-2019)

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  3. Annette Langer-Gould, MD, PhD,
    4. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. My husband currently receives grant support from the NIH, PCORI and NCI

    Research Support, Academic Entities:

    1. I received grant support from the National Institutes of Health (NIH NINDS RO1) and currently an award from PCORI

    Research Support, Foundations and Societies:

    1. I received grant and contract support from the National Multiple Sclerosis Society

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  4. Mitchell T. Wallin, MD, MPH,
    5. Scientific Advisory Boards:

    1. I sit on 1 National Institutes of Health/NINDS Data Safety Monitoring Boards.

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. Editorial Advisory Board: Neuroscience Jounral 2013- present

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. Consultant to the Global Burden of Diseaese Network (non- profit) and PCORI

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. VA Merit Review,BX2625, co-I, 2 years

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. National MS Society

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  5. Jonathan D. Campbell, PhD,
    6. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. (1) Amgen, (2) Astellas, (3) AstraZeneca, (4) Bayer, (5) Boehringer Ingelheim, (6) Mallinckrodt, (7) Teva, (8) Research in Real Life Ltd., (9) Respiratory Effectiveness Group, (10) Institute for Clinical and Economic Review. None of the above listed relationships are directly related to the research presented in this manuscript.

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. Zogenix Inc.

    Research Support, Government Entities:

    1. (1) Colorado State Medicaid, (2) National Institute of Allergy and Infectious Diseases, (3) Agency for Healthcare Research and Quality, (4) National Institutes for Health, National Heart, Lung, and Blood Institute, (5) National Cancer Institute.

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. (1) National Multiple Sclerosis Society , (2) ALSAM Foundation, (3) PhRMA Foundation, (4) The Institute for Clinical and Economic Review, (5) Enterprise Community Partners, Inc.

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  6. Lorene M. Nelson, PhD,
    7. Scientific Advisory Boards:

    1. (1) Neuropace

    Gifts:

    1. NONE

    Funding for travel or speaker honoraria:

    1. (1) ATSDR, Centers for Disease Control travel reimbursement for consultant travel (2) National MS Society travel reimbursement for advisory board travel (3) Muscular Dystrophy Association travel reimbursement for grant review

    Editorial Boards:

    1. Neuroepidemiology, Associate Editor

    Patents:

    1. NONE

    Publishing Royalties:

    1. Neuroepidemiology: From Principles to Practice (Oxford University Press, 2004)

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. (1) Centers for Disease Control, ATSDR, grant 1R01TS000249-01, Principal Investigator, 2016-2019 (2) National Institutes of Health (NINDS), grant 4U01NS038455- 15, Co-Investigator, 2013-2022 (3) Centers for Disease Control, ATSDR, Interagency agreement, ALS Capture-Recapture Analysis, Principal Investigator, 2015-2019 (4) National Institutes of Health, SPO #131896, Site Principal Investigator, 2018-2022 (5) NIH/NCATS, grant 4UL1TR00185-01, Co-Investigator, 2013- 2018

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. (1) National Multiple Sclerosis Society

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. Goldberg-Segalla, expert witness, 2014-2017

  7. Wendy E. Kaye, PhD,
    8. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. McKing Consulting Corporation, Senior Epidemiologist, 13 years

    Consultancies:

    1. Association for the Accreditation of Human Subjects Research Protection Programs (AAHRPP)

    Speakers' Bureaus:

    1. NONE

    Other activities:

    1. At McKing I worked on studies/projects with: The National MS Society Clinical Research Pathways Critical Path Institute US Government, Department of HHS, CDC/ATSDR

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. Contract with the CDC/ATSDR to maintain/operate the National ALS Biorepository 6 years

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. Critical Research Pathways 1 year

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  8. Laurie Wagner, MPH,
    9. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. McKing Consulting Corporation, Research Associate, 7 years

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other activities:

    1. McKing Consulting Corporation Projects: 1. The National MS Society 2. US Governnment, Department of HHS, CDC/ATSDR

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. 1. Contract with the CDC/ATSDR to maintain and operate the National ALS Biorepostiory, 6 years.

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  9. Helen Tremlett, PhD,
    10. Scientific Advisory Boards:

    1. All non-profit: ? National US surveillance system for MS. 2013-present. Invited by the US National MS Society to form an advisory group to enable the development of a national surveillance system capable of tracking the incidence and prevalence of MS. Monthly teleconferences; one face-to-face meeting: Atlanta, Georgia (March 2014) Status: Bipartisan legislation introduced to Congress - ?Advancing Research for Neurological Diseases Act, H.R. 292.?to guide the Centers for Disease Control and Prevention in tracking the incidence and prevalence of neurological diseases, including Multiple Sclerosis and Parkinson?s disease [13th-Jan-2015; http://burgess.house.gov/blog/? postid=397459]

    Gifts:

    1. NONE

    Funding for travel or speaker honoraria:

    1. Helen Tremlett is the Canada Research Chair for Neuroepidemiology and Multiple Sclerosis. Current research support received from the National Multiple Sclerosis Society, the Canadian Institutes of Health Research, the Multiple Sclerosis Society of Canada and the Multiple Sclerosis Scientific Research Foundation. In addition, in the last five years, has received research support from the Multiple Sclerosis Society of Canada (Don Paty Career Development Award); the Michael Smith Foundation for Health Research (Scholar Award) and the UK MS Trust; speaker honoraria and/or travel expenses to attend CME conferences from the Consortium of MS Centres (2013, 2018), the National MS Society (2014, 2016, 2018), ECTRIMS (2013, 2014, 2015, 2016, 2017, 2018), Biogen Idec (2014), American Academy of Neurology (2013, 2014, 2015, 2016). All speaker honoraria are either declined or donated to an MS charity or to an unrestricted grant for use by HT?s research group.

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NONE

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. Canada Foundation for Innovation (CFI); Canadian Institutes of Health Research [#363635 (co-PI); #190898 (PI); #404791; #387503; #388480 (all as PI); #MOP-82738 (PI) and MOP- 119393 (PI) and MOP-106607 (PI)]; the US National Multiple Sclerosis Society (Operating grants: 2012-15; 2014-17), the Multiple Sclerosis Society of Canada (2015-18: EGID #2624 (PI); 2016-18: EGID #2680 (co-PI); ) the The Multiple Sclerosis Scientific and Research Foundation (2015-18 (PI)); Canada Research Chair in Neuroepidemiology and Multiple Sclerosis

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  10. Lie H. Chen, DrPH,
    11. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NONE

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  11. Stella Leung, MSc,
    12. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NONE

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  12. Charity Evans, PhD,
    13. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. 1. Canadian Institutes of Health Research (CIHR) (#388480), Co-PI, 2018-2022 2. CIHR (#363635), PI, 2016-2019 3. Saskatchewan Health Research Foundation (#3821), PI, 2016-2019

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. 1. MS Society of Canada (EGID#2918), PI, 2016-2017

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  13. Shenzhen Yao, MD, MSc,
    14. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NONE

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  14. Nicholas G. LaRocca, PhD;
    15. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NONE

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  15. on behalf of the United States Multiple Sclerosis Prevalence Workgroup (MSPWG)
    1. From the Department of Veterans Affairs Post Deployment Health Services (W.J.C., M.T.W.), Multiple Sclerosis Center of Excellence; University of Maryland (W.J.C.), Baltimore; Departments of Internal Medicine and Community Health Sciences (R.A.M., S.L.), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Neurology Department (A.L.-G., L.H.C.), Kaiser Permanente Southern California, Los Angeles; Georgetown University School of Medicine (M.T.W.), Washington, DC; University of Colorado (J.C.), Denver; Stanford University School of Medicine (L.M.N.), CA; McKing Consulting Corp (W.E.K., L.W.), Atlanta, GA; Faculty of Medicine (Neurology) and Centre for Brain Health (H.T.), University of British Columbia, Vancouver; College of Pharmacy and Nutrition (C.E.), University of Saskatchewan; Health Quality Council (Saskatchewan) (S.Y.), Saskatoon, Canada; and National Multiple Sclerosis Society (N.G.L.), New York, NY.
    1. Correspondence
      Dr. Culpepper William.Culpepper{at}va.gov

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