Public healthcare provision is under increasing economic restraints making an efficient and sustainable managerial planning a necessity in the hospital sector. Business Intelligence is the extraction of business relevant knowledge in order to adjust and refine executive operations. On the free market industries have applied the according methods and software dedicated to the generation of Business Intelligence is offered by variety of companies. Data Mining, furthermore, describes the facilitation of algorithms in order to train programs to detect unseen patterns from huge amounts of data. Therefore mining techniques are suitable for adding to the business relevant knowledge, particularly as they can produce more accurate predictions. The thesis examined the status of Information Technology normally utilized in Austrian hospitals and simultaneously identified studies that apply Data Mining to a Hospital Information System to gain Business Intelligence. While the general level of Austrian Hospital Information Systems is well sophisticated, common challenges are present in a separation between clinical and administrative systems and their interfaces. For the Data Mining a majority of studies aims at medical improvements. Some applications were found to have good business relevant prospects but their feasible introduction into the practice needs additional fostering.

Os Sistemas de Informação Hospitalar podem ser definidos como uma rede integrada de informações, projetada para gerenciar aspectos assistenciais, administrativos e jurídicos em organizações de saúde. No contexto da busca pela melhoria da qualidade na assistência à saúde, proporcionada pelos avanços significativos das tecnologias da informação e comunicação, insere-se a necessidade da abordagem da sepse enquanto importante tema de saúde pública mundial. A sepse pode ser definida como síndrome de anormalidades fisiológicas, patológicas e bioquímicas induzidas por um processo infeccioso. A equipe multiprofissional de saúde deve atuar no reconhecimento precoce dos pacientes com quadro sugestivo de infecção e suas potenciais complicações, que podem culminar em síndrome séptica, estabelecendo medidas que garantam seu controle, manuseio precoce, intervenção eficaz e segura, por meio de uma assistência integral e contínua. O objetivo neste estudo foi verificar a contribuição dos Sistemas de Informação Hospitalar para a identificação precoce e o manejo da sepse em pacientes cirúrgicos de um hospital universitário. Trata-se de pesquisa com delineamento quantitativo, retrospectivo, descritivo e correlacional. A coleta de dados foi realizada por meio dos Sistemas de Informação Hospitalar, mediante aprovação do Comitê de Ética em Pesquisa. A população foi composta de 28 pacientes que atenderam os critérios de inclusão da pesquisa. Na caracterização sociodemográfica desses pacientes, constatou-se predominância do sexo masculino (17; 60,7%), brancos (26; 92,9%), com 60 anos ou mais (21; 75,0%). Quanto à análise clínica do paciente, 11 apresentaram predominância do diagnóstico oncológico (39,3%) na admissão hospitalar, assim como 24 (85,7%) tiveram histórico de somente uma internação hospitalar no período. No final do período de internação (desfecho), predominantemente 20 pacientes (71,4%) evoluíram para óbito. Quanto ao tempo de internação, 13 pacientes (46,4%) permaneceram internados por tempo superior a 30 dias, com média de 30,5 (DP=25,0), a maioria dos pacientes (18; 64,8%) passou pelo procedimento cirúrgico até o quinto dia de internação, com média de 8,25 dias (DP=15,2). Da mesma forma, apresentaram predominância de desenvolvimento dos primeiros sinais de SIRS e de disfunção orgânica também até o quinto dia de internação 19 pacientes (67,8%), com média de 5,2 dias (DP=4,8), e 15 (53,6%), com média de 9,14 dias (DP=12,23), respectivamente. A confirmação ou hipótese do diagnóstico de sepse ocorreu até o décimo dia de internação com 15 pacientes (53,5%), com média de 11,6 (DP=13,4). Na análise da evolução dos pacientes para óbito, identificou-se significância estatística em relação à idade, à especialidade do diagnóstico na admissão e ao tempo de internação. O conteúdo dos registros realizados diariamente pela equipe multidisciplinar evidenciou que os primeiros sinais de SIRS foram identificados, predominantemente, no sistema de monitorização dos pacientes (26; 92,9%), enquanto os primeiros sinais de disfunção orgânica foram descritos nas evoluções da equipe de enfermagem (24; 85,7%). Os resultados evidenciam a importância da qualidade dos registros de enfermagem nos Sistemas de Informações Hospitalares, para identificação dos riscos, reconhecimento precoce e manejo adequado da sepse em pacientes submetidos a procedimentos cirúrgicos, enquanto integrantes da equipe multidisciplinar, visando o alcance de maior efetividade das ações de gerenciamento dos processos de assistência à saúde / Hospital information systems can be defined as an integrated network of information, designed to manage assistance, administrative and legal aspects in healthcare organizations. In the context of the quest for quality improvement in health care, provided by the significant advances of information and communication technologies, the need of sepsis as an important theme of global public health. Sepsis can be defined as abnormalities syndrome, pathological and physiological biochemical induced by an infectious process. The multidisciplinary team of health should act in the early recognition of patients with suggestive of infection and its potential complications, which can lead to septic syndrome, establishing measures to ensure the control, early intervention handling effective and safe, through a full and continuous assistance. The objective of this study was to verify the contribution of hospital information systems for early identification and management of sepsis in surgical patients in a university hospital. This is a quantitative, descriptive, retrospective and correlational research. The data collection was performed through hospital information systems, subject to the approval of the Research Ethics Committee. The population was composed of 28 patients who attended the inclusion criteria of the survey. In demographic characterization of these patients, there was a predominance of males (17; 60.7%), white (26; 92.9%), 60 years or older (21; 75.0%). For the clinical analysis of patient, 11 showed predominance of oncological diagnostics (39.3%) in hospital admission, as well as 24 (85.7%) had a history of only one hospitalization. At the end of the period of hospitalization (outcome), predominantly 20 patients (71.4%) evolved to death. Regarding length of stay 13 patients (46.4%) remained hospitalized for more than 30 days, with an average of 30.5 (SD = 25.0), most patients (18; 64.8%) passed the surgical procedure until the fifth day of hospitalization, averaging 8.25 days (SD = 15.2). Similarly, showed a predominance of development of the first signs of SIRS and organic dysfunction, too, until the fifth day of hospitalization 19 patients (67.8%), with an average of 5.2 days (DP = 4.8), and 15 (53.6%), with an average of 9.14 days (SD = 12.23), respectively. Confirmation or chance of diagnosis of sepsis occur until the tenth day of hospitalization with 15 patients (53.5%), with an average of 11.6 (SD = 13.4). In the analysis of the evolution of the patients to death, statistical significance was identified in relation to age, the speciality of the diagnosis on admission and length of stay. The contents of the records held daily by the multidisciplinary team showed that the first signs of SIRS were identified, predominantly, in the system of monitoring of the patients (92.9%), while 26; the first signs of organic dysfunction were described in the evolutions of the nursing staff (24; 85.7%). The results highlight the importance of the quality of nursing records in hospital information systems, to identify the risks, early recognition and appropriate management of sepsis in patients undergoing surgical procedures, while members of the multidisciplinary team, aiming at the achievement of greater effectiveness of the actions of management of care processes health

This thesis focuses on the development of a GNU Health Module for electrocardiogram monitoring and the development of an application providing a fundamental electrocardiogram analysis. The theoretical part contains a brief introduction to hospital information systems including electronic patient record and healthcare data standards information, followed by a description of the GNU Health application and the implementation of the electrocardiogram analysis, written in the Python programming language. The practical part deals with the development of the GNU Health Monitoring module and the external application for signal analysis. The results, disscussion and the conclusion follow.

Background: Tertiary hospitals have multiple specialist outpatient clinics attended by patients suffering from various comorbid diseases. This results in individuals attending more than one clinic per month, since dedicated clinic days are seldom on the same day. As patients attend discrete clinics, they have separate encounters with various prescribers, increasing the potential for irrational drug use. In addition, multiple clinic visits have a negative socio-economic impact on health care users from poorer communities where financial resources are limited due to transport expenses and days of work missed. The aim of this study was to determine the prescribing pattern of drugs to chronic disease outpatients, and find possible solutions to provide a system that would reduce overprescribing of chronic medication at Steve Biko Academic Hospital (SBAH) in one measure namely drug duplication. Methods: A retrospective descriptive cross-sectional study with the use of convenience sampling was employed to determine the medication prescribing practises to comorbid chronic disease patients attending multiple specialist clinics at SBAH from February 1, 2018-May 31, 2018. Participants were selected according to their appearance in the hospital records, with sample saturation reached when each participant had visited all the different clinics. Chronic disease outpatients attending the SBAH clinics had reviews every three months. The reviews were controlled by issuing patients with medication for a three-month period, where after a follow up visit was mandatory in order to ensure prescription and medication renewal. Therefore, each patient visited all the clinics rendering a service relating to a specific chronic condition within a four-month period that determined the study period chosen. Hospital records of patients attending the most frequently visited clinics as reported by the SBAH Pharmacy and Therapeutics committee (PTC) were evaluated. These clinics included outpatient departments of diabetes, haematology, internal medicine, neurology, oncology and psychiatry. Each drug prescription observed was evaluated using guidelines of World Health Organization (WHO) titled, “How to investigate drug use in health facilities: selected drug use indicators.” Prescribing indicators relevant to this study were used from the WHO guidelines. Results: One hundred and six patients were multiple clinic-attendees during the study period. Of the 106 patients retained, 103 (97.17%) patients attended two clinics and three (2.83%) patients attended three clinics. Regarding the WHO prescribing indicators, the average number of visits to SBAH by the comorbid chronic disease outpatients observed was 3.03 visits during the four-month study period. Prescription analysis included 80 (75.47%) patients out of 106 patients attending multiple clinics at the same time. The average number of drugs prescribed per encounter was 4.97. The results also showed that 45.45% of the 187 prescriptions observed contained five or more drugs. Most frequently prescribed drugs were tramadol 51 (5.49%), followed by simvastatin 48 (5.17%) and enalapril 45 (4.84%). Drug duplication occurred in 68 individual cases in the 80 patients observed. In total, drug duplication affected 39 patients (48.75%) [95% CI = 37.80%: 59.70%]. The most duplicated drug classes were analgesics 18 (26.47%), followed by anti-depressants 14 (20.59%) cases recorded. Conclusion: The results from this study support findings from similar studies at different institutions. The study confirmed multiple clinic visits are prevalent in the medical disciplines, often prescribing drugs from the same class. Clinical implications from these frequent and separate encounters may result in irrational prescribing, adverse drug events, drug-drug interactions and polypharmacy. The establishment of polypharmacy to comorbid chronic disease patients indicates the high risk of drug-drug interactions and adverse drug events. A prospective study would have provided more data for analysis to determine the level of polypharmacy and drug duplication. Thus, supplementation of this study with further studies could provide conclusions on whether the patients suffered from problematic or had appropriate polypharmacy. Physicians treating multiple clinicattendees should be equipped to monitor rationality of prescribing encounters. Installation of an advanced electronic Hospital Information System (HIS) could aid in improving drug prescribing in tertiary hospitals. Use of electronic prescribing tools as shown in previous studies is a requirement to improve tertiary hospitals in developing countries such as SBAH. The incidence of drug duplication at SBAH builds on existing evidence of unnecessary healthcare costs because of medication errors. / Dissertation (MSc)--University of Pretoria, 2020. / Pharmacology / MSc (Pharmacology) / Unrestricted

La question du remplacement des chirurgiens vasculaires pour les années à venir est préoccupante du fait d’un grand nombre de départs en retraite. Mais la question du seul remplacement des effectifs ne suffit pas pour une spécialité qui s’adresse principalement à des patients âgés dans le contexte actuel d’augmentation et de vieillissement de la population française.Dans le but de répondre aux besoins en chirurgie vasculaire dans les années futures, nous avons dans un premier temps réalisé un état des lieux de la démographie des praticiens de la spécialité et estimé la cinétique des départs en retraite des prochaines années.Pour pouvoir tenir compte de l’évolution de la future activité, nous avons établi un modèle prédictif de cette activité concernant les actes de chirurgie carotidienne, de chirurgie des anévrysmes de l’aorte abdominale sous-rénale et de chirurgie des artères sous-inguinales, d’après le seul vieillissement de la population. Ce modèle applique les méthodes de l’INSEE aux actes recueillis dans le Programme Médicalisé des Systèmes d’Information. Nous l’avons ensuite affiné par l’intégration d’autres paramètres influençant l’évolution de l’activité grâce au calcul et à l’application d’un coefficient de pondération obtenu sur la période d’activité de 2000 à 2008. D’après le modèle, l’activité entre 2008 et 2030 augmentera de 38% sur les segments étudiés.Les projections pondérées permettent de prédire une augmentation de l’activité de 30% entre 2011 et 2025. D’un point de vue purement mathématique, les besoins de formation seraient de 120 chirurgiens pour le remplacement des départs en retraite, et de 59 chirurgiens supplémentaires du fait de l’augmentation de l’activité. / The question of replacement of vascular surgeons for the future is of concern because of a large number of retirements. But the question of replacement only is not sufficient for a specialty that is primarily for older patients in the current context of increasing and aging of the French population.In order to meet the need for vascular surgery in the coming years, we initially performed an overview of the demographics of practitioners of the specialty and estimated the retirements. To take into account the evolution of the future activity, we have established a predictive model for the acts of carotid surgery, surgery of infrarenal abdominal aortic aneurysms and surgery of peripheral arterial disease, according to the aging population. This model applies the methods of the INSEE for acts collected in the Medicalised Information System Program database.We then refined it by including other parameters modifying workload evolution. We have calculated and applied a weighting factor obtained during the period of activity from 2000 to 2008. According to the model, the activity between 2008 and 2030 will increase by 38% in the studied procedures.The weighted projections predict an acts’ increase 30% between 2011 and 2025.From a purely mathematical point of view, the training needs of 120 surgeons would be to replace retirements, and 59 more surgeons because of the increased workload.

A despeito de suas limitações, os dados do SIHSUS são os mais sistemáticos e abrangentes sobre as Reações Adversas e Intoxicações a medicamentos que provocam hospitalização. Eles demonstram a importância das ações de educação e investigação de casos do Programa Nacional de Farmacovigilância para possibilitar o diagnóstico mais acurado e superação do quadro atual de ocorrência desses agravos, além da possibilidade de o SIH/SUS ser utilizado sistematicamente como fonte de dados na detecção e análise dos problemas relacionados a medicamentos. No período de 1999 a 2007, foram emitidas 6.670.609 AIH (tipo 1), entre as quais 3.611 foram classificadas como internações devidas a RAM e 4.675 como Intoxicações, correspondendo, respectivamente, às taxas médias de 5,41 casos por 104 AIH e 7,2 casos por 104 AIH. Ocorreram 137 óbitos (3,79% das AIH) por RAM e 207 (4,43% das AIH) por Intoxicações na população internada. Tanto as RAM como as Intoxicações tiveram menor chance de levar ao óbito quando comparados às outras causas. Uma característica da distribuição dos RAM foi concentrar 62% das AIH nas faixas etárias de 20 a 59 anos de idade (grupo adulto). Nas Intoxicações merece destaque a elevada proporção de AIH na faixa etária de 0-4 anos (14,29%). As AIH registradas com causas básicas relacionados a RAM foram principalmente de pacientes do sexo masculino, já as Intoxicações foram principalmente de pacientes do sexo feminino. Em ambos tipos de agravos estes pacientes foram internados em hospitais que não faziam parte da Rede de Hospitais Sentinelas do Programa Nacional de Farmacovigilância. No entanto, a probabilidade destes hospitais registrarem as AIH com códigos CID-10 referentes às RAM é maior, o que ocorre provavelmente por estarem mais capacitados em diagnosticar este tipo de agravo. Porém este fato não foi observado para as Intoxicações. Os fármacos que causaram os agravos estudados são psicoativos. Este estudo apresentou algumas evidências sobre a distribuição da morbi-mortalidade provocada por medicamentos entre pacientes internados em hospitais conveniados ao SUS no período de 1999-2007, baseadas nas informações das AIH, que podem ser úteis ao Programa de Farmacovigilância no Estado do Rio de Janeiro. / Despite its limitations, the data SIHSUS are the most systematic and comprehensive on Adverse Reactions and Drug Poisonings causing hospitalization. They demonstrate the importance of these actions and investigation of cases of National Pharmacovigilance Programme to enable the most accurate and overcoming the current frame of event occurrences diagnosis, beyond the possibility of SIH / SUS be systematically used as a data source in the detection and analysis of drug-related problems. In the period 1999-2007, were issued 6,670,609 AIH (type 1), among which 3,611 were classified as hospitalizations due to poisoning as RAM and 4675, corresponding, respectively, at average rates of 5.41 cases per 104 AIH and 7.2 cases per 104 AIH. There were 137 deaths (3.79% of AIH) by RAM and 207 (4.43% of AIH) by poisoning in hospitalized population. Both the RAM as poisoning were less likely to cause death when compared to other causes. A characteristic distribution of RAM was concentrating 62% of AIH in the age groups 20-59 years of age (adult group). In Poisoning deserves the high proportion of AIH aged 0-4 years (14.29%). The AIH registered root causes related ADRs were mostly male patients, since the poisoning were mainly female patients. In both types of injuries these patients were admitted to hospitals that were not part of the Network of Sentinel Hospitals of the National Pharmacovigilance Programme. However, the likelihood of these hospitals register the AIH with ICD-10 codes related to RAM is higher, which is probably because they are better able to diagnose this type of offense. However this was not observed for the poisoning. The drugs that caused the diseases studied are psychoactive. This study presented some evidence on the distribution of morbidity and mortality caused by drugs among patients admitted to the SUS hospitals during the period 1999-2007, based on the information of AIH, which may be useful to Pharmacovigilance Programme in the State of Rio de Janeiro .

Evaluation is essential for Medical Informatics as well as many other disciplines. There is a growing interest and investment for evaluation researches and self evaluation works. Hospital Information System (HIS) evaluation frameworks have largely been discussed in the literature. However, existing frameworks lack one important aspect, to what extent user expectations from HIS are met. To complement this deficiency we designed an evaluation farmework for evaluating the user expectation in HIS. User expectation data are collected by means of &ldquo / Expectation Questionnaire&rdquo / . Fuzzy logic methodologies are used to evaluate the expectation meeting in the proposed evaluation framework. The evaluation variables are not represented in the result equally / they are reflected by the weights assigned by the users. Our proposed framework provides the overall degree to what extent user expectations are met. It also gives the opportunity to analyze to what extent each expectation is met and degree to what extent different user groups&rsquo / expectations are met. Education, sex and business title is determinants of general expectations about HIS. IS experience is not a determinant of medical users&rsquo / expectations in any expectations. The proposed framework is not a rival but an alternative or complementary to the existing frameworks. It is a different approach and has different computation methodology supported by fuzzy logic. The framework can give detail to the each variable level. These results are just a photo of the current situation / a deeper analysis of these findings must be done for further information about the causes of these results.

No description available.

A despeito de suas limitações, os dados do SIHSUS são os mais sistemáticos e abrangentes sobre as Reações Adversas e Intoxicações a medicamentos que provocam hospitalização. Eles demonstram a importância das ações de educação e investigação de casos do Programa Nacional de Farmacovigilância para possibilitar o diagnóstico mais acurado e superação do quadro atual de ocorrência desses agravos, além da possibilidade de o SIH/SUS ser utilizado sistematicamente como fonte de dados na detecção e análise dos problemas relacionados a medicamentos. No período de 1999 a 2007, foram emitidas 6.670.609 AIH (tipo 1), entre as quais 3.611 foram classificadas como internações devidas a RAM e 4.675 como Intoxicações, correspondendo, respectivamente, às taxas médias de 5,41 casos por 104 AIH e 7,2 casos por 104 AIH. Ocorreram 137 óbitos (3,79% das AIH) por RAM e 207 (4,43% das AIH) por Intoxicações na população internada. Tanto as RAM como as Intoxicações tiveram menor chance de levar ao óbito quando comparados às outras causas. Uma característica da distribuição dos RAM foi concentrar 62% das AIH nas faixas etárias de 20 a 59 anos de idade (grupo adulto). Nas Intoxicações merece destaque a elevada proporção de AIH na faixa etária de 0-4 anos (14,29%). As AIH registradas com causas básicas relacionados a RAM foram principalmente de pacientes do sexo masculino, já as Intoxicações foram principalmente de pacientes do sexo feminino. Em ambos tipos de agravos estes pacientes foram internados em hospitais que não faziam parte da Rede de Hospitais Sentinelas do Programa Nacional de Farmacovigilância. No entanto, a probabilidade destes hospitais registrarem as AIH com códigos CID-10 referentes às RAM é maior, o que ocorre provavelmente por estarem mais capacitados em diagnosticar este tipo de agravo. Porém este fato não foi observado para as Intoxicações. Os fármacos que causaram os agravos estudados são psicoativos. Este estudo apresentou algumas evidências sobre a distribuição da morbi-mortalidade provocada por medicamentos entre pacientes internados em hospitais conveniados ao SUS no período de 1999-2007, baseadas nas informações das AIH, que podem ser úteis ao Programa de Farmacovigilância no Estado do Rio de Janeiro. / Despite its limitations, the data SIHSUS are the most systematic and comprehensive on Adverse Reactions and Drug Poisonings causing hospitalization. They demonstrate the importance of these actions and investigation of cases of National Pharmacovigilance Programme to enable the most accurate and overcoming the current frame of event occurrences diagnosis, beyond the possibility of SIH / SUS be systematically used as a data source in the detection and analysis of drug-related problems. In the period 1999-2007, were issued 6,670,609 AIH (type 1), among which 3,611 were classified as hospitalizations due to poisoning as RAM and 4675, corresponding, respectively, at average rates of 5.41 cases per 104 AIH and 7.2 cases per 104 AIH. There were 137 deaths (3.79% of AIH) by RAM and 207 (4.43% of AIH) by poisoning in hospitalized population. Both the RAM as poisoning were less likely to cause death when compared to other causes. A characteristic distribution of RAM was concentrating 62% of AIH in the age groups 20-59 years of age (adult group). In Poisoning deserves the high proportion of AIH aged 0-4 years (14.29%). The AIH registered root causes related ADRs were mostly male patients, since the poisoning were mainly female patients. In both types of injuries these patients were admitted to hospitals that were not part of the Network of Sentinel Hospitals of the National Pharmacovigilance Programme. However, the likelihood of these hospitals register the AIH with ICD-10 codes related to RAM is higher, which is probably because they are better able to diagnose this type of offense. However this was not observed for the poisoning. The drugs that caused the diseases studied are psychoactive. This study presented some evidence on the distribution of morbidity and mortality caused by drugs among patients admitted to the SUS hospitals during the period 1999-2007, based on the information of AIH, which may be useful to Pharmacovigilance Programme in the State of Rio de Janeiro .

Η πολλαπλή σκλήρυνση (σκλήρυνση κατά πλάκας) είναι ένα αυτοάνοσο νόσημα που χαρακτηρίζεται απομυελινωτικές βλάβες που οδηγούν σε καταστροφή νευραξόνων επηρεάζοντας τις λειτουργίες του ανθρώπινου οργανισμού. Οι ασθενείς παρουσιάζουν νευρολογικά ελλείμματα σε διαφορετικές τοποθεσίες και σε διαφορετικούς χρόνους. Η πολλαπλή σκλήρυνση εμφανίζεται σε κάθε ηλικία, ακόμα και στα παιδιά, αλλά είναι σαφώς συχνότερη σε νέους ανθρώπους 20-40 ετών και ειδικά στις γυναίκες. Μετά από ένα αρχικό επεισόδιο απομυελίνωσης, η σκλήρυνση κατά πλάκας μπορεί να ακολουθήσει ένα από τα τρία διαφορετικά μοτίβα: υποτροπιάζουσα, πρωτογενής προοδευτική, ή δευτερογενής προϊούσα, μετά από μια υποτροπιάζουσα φάση. Η ιατρική παρακολούθηση και παρέμβαση με θεραπείες απαιτεί ένα σύνολο από επαναλαμβανόμενες εργαστηριακές εξετάσεις. Η πορεία της νόσου χαρακτηρίζεται αδιαμφισβήτητα από συσσώρευση αναπηρίας που οδηγεί τον ασθενή σε χρήση βοηθημάτων κίνησης έως και ανάγκη φροντιστή. Ένας σύγχρονος ιατρικός φάκελος είναι ιδιαίτερα χρήσιμος μιας και οι νεότερες και αποτελεσματικότερες θεραπείες απαιτούν λεπτομερές ιστορικό του ασθενούς. Στην παρούσα εργασία θα αναπτυχθεί μια βάση δεδομένων σε γλώσσα mysql, διεπαφή με γλώσσα php. / Multiple Sclerosis is a chronic, inflammatory, demyelinating disease of the central nervous system (CNS) and is one of the most common causes of neurological disability in young adults. It is characterized by multi-focal recurrent attacks of neurological symptoms and signs with variable recovery. Eventually, the majority of patients develop a progressive clinical course . The exact cause of multiple sclerosis is unknown, although an autoimmune process has been implicated. The clinical course of MS is highly variable, ranging from sub-clinical disease to rapidly progressive MS. The major rationale for the MSBase project is the creation of a base platform to facilitate the clinical practice. The MSBase is dedicated to providing doctors who want to help ms patient with the best possible independent logistic solution to the challenges of the disease at no cost.