Abstract
NOT ENTIRELY tongue in cheek, Labe C. Scheinberg, MD, professor of neurology and rehabilitation at New York City's Albert Einstein College of Medicine of Yeshiva University, observes that "those whom the gods wish to destroy, they first have do clinical trials in multiple sclerosis." For at least the last 20 years, investigators have publicly and privately grappled with a crucial problem: how to design and evaluate clinical trials in a field whose history is strewn with failed therapies, whose patients enter trials carrying with them unknown prognoses and histories of prior treatments, and whose financial resources are strained to the limit. At the American Academy of Neurology meetings in New Orleans, these problems again bubbled to the surface. This time, though, there was nearly unanimous agreement that clinical trials have markedly improved, and that—even in the absence of "a cure"— more broadly designed rehabilitation strategies can do much to help
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