Clinical Considerations

  • John F. Kurtzke
Part of the Foundations of Neurology book series (FONY, volume 1)


There is really only one purpose for any therapeutic trial, and that is to assist physicians in the decisions they must make in treating their patients. An essential difference between clinicians and basic scientists is their reaction to problems presented to them: the latter can repeat their experiments, apply for a new grant, or hold a conference; the former must act. And usually, the more acute the problem, the less the available information is on which even to base diagnosis — and without diagnosis, therapy can be little more than guesswork. However, granted that we know what is wrong with the patient, the next question obviously is what to do about it. The answer requires a solid knowledge of the natural history of the disorder, including its course and prognosis. Assuming an illness that will not be self-limited and that is more than trivial, we then seek a treatment. Our choices may be chemical, immunologic, surgical, electromagnetic, or manipulative — or any combination thereof. And the choice not to use any modality (one or all) is just as positive a decision as its opposite.


Multiple Sclerosis Treatment Trial Therapeutic Trial Drug Trial Concurrent Control 
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© Kluwer Academic Publishers 1990

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  • John F. Kurtzke

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