Atormac
brintellex
Neurology India
menu-bar5 Open access journal indexed with Index Medicus
  Users online: 2180  
 Home | Login 
About Editorial board Articlesmenu-bullet NSI Publicationsmenu-bullet Search Instructions Online Submission Subscribe Videos Etcetera Contact
  Navigate Here 
 Search
 
  
 Resource Links
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Article in PDF (367 KB)
    Citation Manager
    Access Statistics
    Reader Comments
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this Article
   References

 Article Access Statistics
    Viewed1332    
    Printed14    
    Emailed0    
    PDF Downloaded48    
    Comments [Add]    

Recommend this journal

 


 
Table of Contents    
CORRESPONDENCE
Year : 2016  |  Volume : 64  |  Issue : 2  |  Page : 360-361

Arriving at natural history of a disease


Department of Community Medicine, Dr. Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India

Date of Web Publication3-Mar-2016

Correspondence Address:
Sunil Kumar Raina
Department of Community Medicine, Dr. Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.177665

Rights and Permissions



How to cite this article:
Raina SK. Arriving at natural history of a disease. Neurol India 2016;64:360-1

How to cite this URL:
Raina SK. Arriving at natural history of a disease. Neurol India [serial online] 2016 [cited 2020 Nov 28];64:360-1. Available from: https://www.neurologyindia.com/text.asp?2016/64/2/360/177665


Sir,

I went through with interest the article entitled, “Natural history of multiple sclerosis from the Indian perspective: Experience from a tertiary care hospital” published in Neurology India (2015; 63:866-73),[1] the authors deserve credit for their effort in exploring the natural history of multiple sclerosis. I am of the opinion that research in India should definitely focus on natural history of diseases, as this will generate data specific to the Indian context on how the diseases progress in India; and, on which interventions to plan to obtain maximum benefits for the patients.

However, I have a small concern with the study. The authors have titled the study as “Natural history,” but have not in actual reported on the natural history.

Natural history of disease (multiple sclerosis in this case) would mean the progression of a disease process in an individual over time, in the absence of treatment/intervention. It signifies the way in which a disease evolves over time from the earliest stage of its prepathogenesis phase to its termination as recovery, disability, or death, in the absence of treatment or prevention. Each disease has its own unique natural history, which is not necessarily the same in all individuals. Hence, establishing natural history is not easy. The best way of establishing this is by way of cohort studies. The difficulty with hospital-based studies arises because what a patient generally records is an episode in the natural disease, and once an intervention/treatment is initiated on the basis of this episode, the natural history of the disease changes. Now, this study has entirely been based on hospital data; therefore, all the study participants have undergone an intervention meaning this study is not actually reporting the natural history.

Finally, the authors need to revisit their conclusion wherein they state that a high incidence of opticospinal presentation, predominance of relapsing-remitting multiple sclerosis, and a low yield on cerebrospinal fluid studies are the major findings of our study. The study methodology is inadequate to arrive at incidence. The incidence is basically a “rate” and is the number of new cases per population at risk in a given time period.[2]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Jena SS, Alexander M, Aaron S, Mathew V, Thomas MM, Patil AK, et al. Natural history of multiple sclerosis from the Indian perspective: Experience from a tertiary care hospital. Neurol India 2015;63:866-73.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.
Raina SK. Central nervous system lymphoma: Patterns of incidence in Indian population and effect of steroids on stereotactic biopsy yield. Neurol India 2014;62:343-4.  Back to cited text no. 2
[PUBMED]  Medknow Journal  




 

Top
Print this article  Email this article
   
Online since 20th March '04
Published by Wolters Kluwer - Medknow