Case finding for epidemiological surveys of multiple sclerosis in United States communities

In regard to prevalence surveys of MS in US communities, this article considers the relative merits of case finding through hospitals, physicians, MS service organisations, neurology practices, death certificates, chronic care facilities and media announcements and lay referrals. The current value of hospitals and non-neurological practitioners for case finding is questionable, given the changes in clinical practice with respect to MS and the data collection problems inherent with surveys of physicians. We suggest giving priority to the following case-finding methods: manually reviewing patient records of neurology practices, screening patient rolls of local MS service organisations and surveying chronic care facilities. In some US communities, these methods may need to be augmented by also surveying internists, general practitioners and family practitioners. Capture-recapture methodology offers a way to evaluate the completeness of case ascertainment.