For Physicians

How to make a referral

Please send us these documents:

• Copies of all performed MS-related imaging studies (i.e., MRI of the brain and spinal cord
• Results of other diagnostic studies that were performed as a part of the work-up for possible MS (e.g., results of the lumbar puncture, visual-evoked potentials, etc.)
• Referral letter, by mail or e-mail, with brief description of the question or problem you want us to address

On-line MS-questionnaire completed by the patient »

Appointment procedures

Please send all information to:
Waddell Center for MS
Medical Arts Building
222 Piedmont Avenue, Suite 3200
Cincinnati, OH 45219
Phone: 513-475-8775
Fax: 513-475-7352 (Please put Attn: Kim DiPilla)

After all information has been received, a scheduling associate will contact the patient to set up an appointment.

Clinical studies and referrals

Complete Listing of Ongoing Adult Clinical Trials »
 

• Clinical trials in progress at the Waddell Center are summarized in the research section, which also specifies inclusion and exclusion criteria for individual studies.
• Patients can be referred for consideration in future clinical studies if they have primary-progressive MS (PP-MS) or if they have experienced inadequate response to available immunomodulatory/immunosuppressive therapies.
• Patients must fill out and submit the online MS questionnaire before visiting our office.
• Contact Kimberly DiPilla at 513-475-8775 or Kimberly.Dipilla@uc.edu to discuss further.

Links to research sites of note:
National Institutes of Health »
ClinicalTrials.GOV »
US Department of Health and Human Services »
Food and Drug Administration »
Understanding Clinical Trials »

Our Goals and Services

1. To provide comprehensive and standardized diagnostic service to primary care physicians in suspected MS cases »

2. To provide consultation and therapeutic services to neurologists for the management of difficult MS cases »

3. To identify, together with general neurologists and the Ohio Valley Chapter of the National MS Society, the most pressing needs for MS patients in the Greater Cincinnati area and to focus our research activities and community outreach efforts on meeting those needs »

4. To establish a database of MS patients with insufficient therapeutic response to FDA-approved therapies who might benefit from clinical trials involving new or experimental therapies »

5. To promote and actively support awareness of MS in the community and the education of patients, caregivers, and physicians who care for people with MS »

1. Waddell Center specialists offer a highly comprehensive, standardized diagnostic protocol to primary care physicians and general neurologists for their patients with a suspected diagnosis of MS.

Patients who present with first symptoms consistent with a demyelinating event should undergo an imaging study (ideally an MRI of the brain and/or spinal cord) to rule out alternative etiologies or causes, such as vascular events or a tumor. If the MRI is consistent with a demyelinating event, Waddell Center specialists will perform the rest of the diagnostic work-up if the patient is referred to them.

The advantages of performing a diagnostic work-up at the Waddell Center are:

• Waddell Center specialists use a highly comprehensive and standardized laboratory protocol that focuses on the elimination of alternative diagnoses and on the determination of factors that suggest activation of the immune system. This is achieved with peripheral blood and the diagnostic lumbar puncture.
• Waddell Center specialists use a standardized MRI imaging protocol that is optimized for the detection of abnormalities of the white matter of the CNS. In addition, Waddell Center specialists have access to volumetric MRI measures, thanks to our participation in an imaging consortium of MS centers. Use of this standardized imaging MRI protocol at the very beginning of the disease process allows for sophisticated longitudinal analysis of a patient’s status. Such an analysis may prove exceptionally valuable later by helping answer questions about the patient’s responses to therapies and his or her disease progression.
• Waddell Center specialists adhere to state-of-the art MS diagnostic criteria; their diagnostic process is exact and leaves little doubt later about the completeness of the diagnosis. In addition, Waddell Center specialists will perform follow-up MRIs at 3 and 6 months after the first event, if required.
• If a diagnosis of MS is confirmed, Waddell Center specialists will provide extensive patient teaching and will recommend the most appropriate therapy. If the referring physician so desires, Waddell Center clinicians will follow the newly diagnosed patient on selected therapy until they are assured that the patient’s disease has stabilized. The determination of whether a patient has experienced an adequate therapeutic effect is based both on clinical grounds and longitudinal MRI data.
• Patients who participate in a diagnostic work-up at the Waddell Center will have an option to join the Waddell Center’s research protocol, which examines biomarkers of immune activation and immune function, biomarkers of neurodegeneration, and others.

The Waddell Center has a streamlined screening process for referred patients. (See our online questionnaire). Upon receiving the referral documentation (patient questionnaire and MRI data, plus any additional work-up the patient may have undergone) and determining that the patient has possible MS, a clinical visit with one of the Waddell Center specialists will be scheduled.

Polman, C.H. et al. Diagnostic criteria for multiple sclerosis: 2005 revisions to the "McDonald Criteria". Ann Neurol 58, 840-846 (2005).
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2. Waddell Center specialists offer consultation and services to physicians who care for MS patients who suffer from very active MS and who continue to accumulate disability despite FDA-approved disease-modifying therapies. Waddell clinicians can offer advice regarding the management of these MS patients or, at the request of the referring physician and patient, can provide therapeutic services until the patient’s disease has stabilized.

Waddell Center specialists also can provide information about therapeutic trials in the region that may be appropriate for, and of benefit to, the patient.

The Waddell Center has a streamlined screening process for referred patients (please see our on-line questionnaire). Upon receiving the referral documentation and MRI data and determining that the patient possibly has MS, a clinical visit with one of the Waddell Center specialists will be scheduled.

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3. The Waddell Center is committed to improving the care and well-being of MS patients in the Greater Cincinnati area. We strive to collaborate closely with primary care physicians and neurologists in the community and with the Ohio Valley Chapter of the National MS Society in order to identify patient needs and to develop programs that address those needs.

As researchers, Waddell Center specialists are committed to focusing their research efforts in areas that are most lacking in development. As such, we are striving to:

• Develop novel immunomodulatory therapies for patients who are failing standard FDA-approved therapies
• Develop neuroprotective therapies and repair strategies for patients with MS
• Identify biomarkers that would predict patient response to different therapies
• Identify biomarkers that would indicate the prevailing pathophysiological mechanism of disease (i.e., MS disease heterogeneity)

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4. Unfortunately, FDA-approved immunomodulatory therapies currently available do not provide sufficient therapeutic benefit for all MS patients. Use of the harsh immunosuppressive agents, although indicated in special cases with evidence of prominent destructive inflammation, may have additional deleterious effects on remyelination and repair. Therefore, new therapies with better risk/benefit ratios, and especially experimental therapies with neuroprotective potential, are urgently needed for patients who are experiencing unsatisfactory results from their treatments.

To facilitate the development and testing of such novel therapies in Greater Cincinnati, the Waddell Center is collecting data on patients with insufficient therapeutic response to FDA-approved therapies. Therefore, physicians caring for MS patients are encouraged to refer patients who are failing standard therapeutic options for evaluation at the Waddell Center. Patients also may indicate their wish to be considered for participation in MS research in the Greater Cincinnati area by filling out the Center’s on-line questionnaire and by indicating their wish to be included in the database of possible future trial participants.

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5. As a part of our commitment to improving the lives of all MS patients in the Greater Cincinnati area, Waddell Center specialists provide lectures and updates on MS to community physicians, patients, families, and support groups.

Educational materials for patients and their caregivers developed for this Web page are part of this ongoing effort to promote and actively support MS awareness and education in the community.

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