Background: While studying the etiology of multiple sclerosis (MS) in children has several methodological advantages over studying etiology in adults, studies are limited by small sample sizes. Objective: Using a rigorous methodological process, we developed the Pediatric MS Tool-Kit, a measurement framework that includes a minimal set of core variables to assess etiological risk factors. Methods: We solicited input from the International Pediatric MS Study Group to select three risk factors: environmental tobacco smoke (ETS) exposure, sun exposure, and vitamin D intake. To develop the Tool-Kit, we used a Delphi study involving a working group of epidemiologists, neurologists, and content experts from North America and Europe. Results: The Tool-Kit includes six core variables to measure ETS, six to measure sun exposure, and six to measure vitamin D intake. The Tool-Kit can be accessed online (www.maelstrom-research.org/mica/ network/tool-kit). Conclusion: The goals of the Tool-Kit are to enhance exposure measurement in newly designed pediatric MS studies and comparability of results across studies, and in the longer term to facilitate harmonization of studies, a methodological approach that can be used to circumvent issues of small sample sizes. We believe the Tool-Kit will prove to be a valuable resource to guide pediatric MS researchers in developing study-specific questionnaire.

Additional Metadata
Keywords Multiple sclerosis, pediatrics, etiology, risk factors, questionnaires, sunlight, vitamin D, tobacco smoke pollution
Persistent URL dx.doi.org/10.1177/1352458518783345, hdl.handle.net/1765/117710
Journal Multiple Sclerosis: clinical and laboratory research
Citation
Magalhaes, S., Banwell, B, Bar-Or, A, Fortier, I, Hanwell, H.E., Lim, M, … Wolfson, C. (2018). A framework for measurement and harmonization of pediatric multiple sclerosis etiologic research studies: The Pediatric MS Tool-Kit. Multiple Sclerosis: clinical and laboratory research, 25(8), 1170–1177. doi:10.1177/1352458518783345