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Multiple Sclerosis Expert Advisory Group

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Multiple Sclerosis Expert Advisory Group

Ministry of Health

Ontario is establishing an expert advisory group to provide advice on follow-up care and treatment of people with multiple sclerosis (MS) who return to Ontario after undergoing an experimental procedure in other jurisdictions.

Specifically, the group will develop recommendations and best practice guidelines on follow-up care for MS patients who undergo the Chronic Cerebro-Spinal Venous Insufficiency (CCSVI) procedure outside Canada.

The CCSVI procedure involves an angioplasty of veins in the head and/or neck.  During a venous angioplasty, with the help of imaging devices, a long, thin plastic tube, capped by a deflated balloon is inserted in a vein and advanced to where the vein is narrow or blocked. The balloon is then inflated to open the vein, deflated and removed.  The procedure may also involve stents which are intended to keep the vein open.

At this time, the experimental CCSVI procedure is not an insured service in Ontario, or any other province or territory in Canada because there is insufficient evidence that it is safe and effective.

Expert Advisory Group Members

Dr. Barry Rubin runs a tertiary/quaternary care practice in vascular surgery, and manages patients with a wide range of vascular diseases, including thoracic and abdominal aortic aneurysms, carotid (neck artery) stenosis, impaired circulation to the lower extremities and complex venous disease. He has been the head of the division of vascular surgery at the University Health Network since 2004, and was appointed medical director of the Peter Munk Cardiac Centre in 2010. Dr. Rubin's basic science research laboratory has been continuously funded by the Canadian Institutes of Health Research for 14 years. His basic science work focuses on the way the heart responds to injury and the regulation of the immune response to infection, and has been widely published in high impact journals.

Dr. Paul O'Connor has been a leader in multiple sclerosis neurology in Canada for more than 20 years. He is Director of the MS Clinic at St. Michael's Hospital in Toronto and a Professor in the Department of Medicine (Neurology) at the University of Toronto. He also holds the Waugh Family Chair in MS Research and is the National Scientific and Clinical Advisor for the MS Society of Canada. As director of the MS Clinic at St. Michael's Hospital MS Clinic, he heads one of the largest and most active research clinics in the country. He is well known for his expertise in clinical trials and has been principal investigator of a number of MS research studies in the past decade, publishing well over 100 peer-reviewed articles on MS research. He is president-elect of the America's Committee on Treatment and Research in MS. 

Dr. David Henry, president and CEO of the Institute of Clinical Evaluative Sciences, is an experienced physician, general internist and clinical pharmacologist. He has carried out extensive research into the benefits harms and costs of prescription medicines in high and low income countries and has previously worked with the World Health Organisation.  He is an authority on cost effectiveness in drug selection processes and was a member of the Australian national Pharmaceutical Benefits Advisory Committee. He was also involved in the establishment of the Australian system for evaluating new health technologies and is currently a member of the Ontario Health Technology Advisory Committee.

Dr. Marcelo Kremenchutzky is the director of the Multiple Sclerosis Clinic in London. He is a consultant neurologist at the London Health Sciences Centre - University Hospital, a scientist in the clinical neurosciences program at the Lawson Health Research Institute, and an associate professor (neurology) in the department of clinical neurological sciences at the University of Western Ontario (Schulich School of Medicine and Dentistry). Dr. Kremenchutzky is a member of a number of leading neurology societies including Canadian, American and European organizations. His areas of interest, in addition to the practice of Clinical Neurology, are university teaching, public education and neuroscience research.

Dr. Julian Spears is the co-director of the neurovascular program at St. Michael's Hospital. He is also an adjunct scientist in the Keenan Research Centre of the Li Ka Shing Knowledge Institute at St. Michael's Hospital, assistant professor of surgery/neurosurgery at St. Michael's Hospital, and assistant professor of medical imaging at the hospital. Dr. Spears specializes in neurosurgery and endovascular neurosurgery and has done research into neurovascular disease, cerebral aneurysms and cartoid artery disease.

Dr. Liesly Lee is a consultant neurologist at the Sunnybrook Health Sciences Centre and the director of the Sunnybrook MS clinic.  He completed his training in Neurology at the University of Toronto in 1997 and completed one year of fellowship training in MS.  His interests include clinical trials in MS, general neurology, including medicine in the developing world.  Areas of interest in MS include: quality of life, role of rehabilitative devices and various novel agents in the treatment of MS.  He is currently an assistant professor of Medicine (Neurology) at the University of Toronto, and is actively involved in the Neurology teaching program in both the undergraduate and graduate levels at the university. 

Dr. Andreas Laupacis is a General Internist, and since 2006 he has been the executive director of the Li Ka Shing Knowledge Institute at St. Michael's Hospital, Toronto. He is also a professor in the Departments of Medicine and Health Policy Management and Evaluation at the University of Toronto. Dr. Laupacis has published over 280 articles in peer-reviewed journals, and has had a number of senior advisory and governance roles in health care. Dr. Laupacis's research interests include: pharmacoeconomics and drug policy, health policy, diagnostic imaging, health services research, knowledge translation, clinical epidemiology, and citizen engagement.

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