How Do I…? An Integrated CME Activity Designed to Assess and Compare the Clinical Decisions of Multiple Sclerosis Specialists and General Neurologists (Credit Expired)

Program Description

Multiple Sclerosis impacts nearly 1 million people in the US and is the leading cause of non-traumatic disability in adults under the age of 50. Accordingly, substantial time and energy has been dedicated to improving understanding of its biological underpinnings and subsequent therapy development. As a result, there are now 18 different disease modifying therapies available representing nine therapeutic classes with several additional options poised to join them. Without direct comparisons of many of these drugs and with only recent guidelines to help piece through the sheer volume of options and opinions, the field of MS can be exceedingly complex to manage. Little publicly available information exists about how practicing neurologists are approaching the contemporary diagnosis and treatment of this population.
This 3-part program is designed to help elucidate the practice patterns of community neurologists and place them side by side those of the MS experts. A sample of each of these groups were given identical case-based and practical questions for completion. The comparative results and their implications for standard practice will be discussed to help clarify and enhance understanding of the contemporary clinical landscape and the nuances of MS specialists that can be adopted to help guide routine practice.

Target Audience

This activity is intended for neurologists, nurse practitioners, physician assistants, pharmacists, and other providers involved in the care of patients with MS.

Learning Objectives

Activity 1: Diagnosis and Progression Monitoring
  • Compare and contrast your diagnostic and monitoring approaches for patients with diverse presentations of MS to physicians that specialize in the care of the disease and affirm or modify your planned decision-making accordingly.
  • Develop a thorough understanding of the revised McDonald Criteria for the diagnosis of patients with relapsing and progressive forms of MS in an effort to enhance the proper and timely identification of these individuals in routine neurology practice.
Activity 2: Initiation and Selection of Disease Modifying Therapy
  • Understand how to utilize clinical factors (e.g. age of onset, disease status) to accurately risk stratify individuals diagnosed with MS, and use this information in designing an appropriate management plan.
  • Appraise available research data on the risks and benefits associated with the use of "induction" versus "'escalation" approaches to the integration of disease modifying therapy (DMT) and consider this information when counseling patients with MS regarding available treatment options.
Activity 3: Navigating Controversy - Prognostic Factors, Breakthroughs, and Biomarkers
  • Assess the potential impact of specific prognostic and clinical factors (e.g. pregnancy, race, OCT findings) to assist in the development of individualized treatment plans for patients with MS.
  • Assess clinical investigator perspectives regarding breakthrough disease management, including the indications for DMT discontinuation and/or switching in individuals receiving active treatment, to inform these decisions in clinical practice.
  • Recognize the potential clinical role of emerging biomarkers (e.g., neurofilament light chain) to assist in the diagnosis, risk stratification and/or identification of disease progression of patients with MS.
Course summary
Course opens: 
Course expires: 

   Robert Bermel, MD
   Staff Neurologist and
   Director, Mellen Center for Multiple Sclerosis
   Cleveland Clinic
   Cleveland, Ohio
Dr. Bermel is a board certified neurologist and the director of the Mellen Center for Multiple Sclerosis (MS) at the Cleveland Clinic. He is widely recognized for his contributions to the field of neurology with a particular focus on MS research. He is actively involved at the forefront of pharmacological and technological advancement in MS and has been a frequent presenter of such advances at ACTRIMS and ECTRIMS as well as a consulting authority throughout the field.


   James Stankiewicz, MD
   Assistant Professor of Neurology
   Harvard Medical School
   Clinical Director, Partners Multiple Sclerosis Center
   Boston, Massachusetts
Dr. Stankiewicz is an assistant professor of neurology at Harvard Medical School and the clinical director for the Partners Multiple Sclerosis Center. He is involved in both medical and charitable endeavors among the MS community with current positions serving as topic co-chair at the American Academy of Neurology's annual meeting for MS and CNS Inflammatory Disease as well as on the medical advisory board of The Assistance Fund. He additionally co-edits the broadly utilized textbook, Multiple Sclerosis: Principles of Diagnosis and Treatment, helping to guide practicing physicians across the field.


   Adnan Subei, DO
   Medical Director, Multiple Sclerosis Program
   Memorial Healthcare System Neuroscience Institute
   Hollywood, Florida 
Dr. Subei is a board certified neurologist and medical director for the MS program at Memorial Healthcare System Neuroscience Institute. Has been awarded multiple fellowship grants from the American Academy of Neurology and the National Multiple Sclerosis Society and specialized in both neuro-visual and neuro-immunological disorders. He continues an active interest in research while at Memorial Healthcare where he has been since completing his fellowship at the Cleveland Clinic Mellen Center for Multiple Sclerosis Treatment and Research.


Credit for this program has expired. The accreditation information below is based on the activity release date.
Estimated Credit Hours
Postgraduate Institute for Medicine will provide up to 1.75 AMA PRA Category 1 Credits™ to learners for their participation in the web-based elements of the activity.

About PIM
The Postgraduate Institute for Medicine (PIM) has been providing trusted independent continuing education for healthcare professionals for over 35 years and is a recognized leader for jointly provided CME/CE activities. The purpose of the PIM continuing healthcare education program is to deliver effective CME/CE activities that are designed to contribute to the professional development of physicians and other healthcare professionals, support the development and function of collaborative interprofessional teams, and positively impact the delivery of healthcare. We fulfill this mission by forming successful alliances and working in collaboration to deliver impactful educational experiences that are designed to improve patient care practices.

In support of improving patient care, PIM is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. PIM is one of a very select group of jointly accredited providers that has been awarded the highest level of a 6-year term, placing PIM among the top echelon of CME/CE providers that have demonstrated the highest levels of educational acumen in providing healthcare professionals with relevant, effective, practice-based continuing education that supports US health care quality improvement.
PIM is also accredited by the American Academy of Physician Assistants (AAPA), the Association of Regulatory Boards of Optometry's Council on Optometric Practitioner Education (ARBO/COPE), the Association of Social Work Boards (ASWB), the International Association for Continuing Education and Training (IACET), the Commission on Dietetic Registration (CDR), the American Psychological Association (APA) as a sponsor of CE for psychologists and the American Dental Association (ADA) as a Continuing Education Recognition Program (CERP) recognized provider. PIM is authorized to award pre-approved Qualified Education credit by the American College of Healthcare Executives (ACHE) and is approved as a provider of continuing education programs in the clinical laboratory sciences by the American Society for Clinical Laboratory Sciences’ Professional Acknowledgment for Continuing Education (P.A.C.E.®) Program.
PIM is composed of a staff of dedicated professionals who represent a unique blend of educational and clinical talent, as well as statistics acumen. Eight (8) of these individuals are Certified Healthcare Continuing Professional Development Professionals (CHCPs), and 3 PIM staff members hold clinical degrees, including 2 PharmDs and 1 master’s prepared registered nurse. The PIM team is rounded out by a PhD researcher with expertise in adult learning principles and outcomes analysis and a biostatistician that holds a master’s degree in public health statistics.
Commercial Supporter
This serial activity is supported by an educational grant from Genentech, A Member of the Roche Group.
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