Correspondence (reply): In Reply

The reader’s letter reminds us of the early epidemiological studies in Hesse and southern Lower Saxony, which yielded important results about the prevalence of MS in circumscribed areas, in a population-based approach. We were fully aware of those publications – directional in their day – as is obvious from the fact that these were included in the text and illustrations in more recent review articles on the epidemiology of MS (1, 2). As we pointed out briefly in the discussion of our paper, the MS registry is not a population-based study. When a center-based approach is used, in the setting of Germany’s current healthcare structures, a blanket coverage, population-based study is an impossibility. Because of the limited word count in our article, we could not include a detailed discussion of epidemiological studies conducted so far – we would have had to include results not only from Darmstadt and Göttingen, but also from Rostock and Halle, the Ruhr-Rhine area, the Vogtland (southwestern Saxony), and other German regions. The MS registry aims to describe healthcare provision for patients with MS as comprehensively for Germany as possible – in contrast to Prof. Firnhaber, who aims to set out reliable prevalence, incidence, and mortality data. We are delighted that some of our results have confirmed earlier findings from regional studies, but we think that the data on diagnosis and treatment that we presented in our article constitute an important and innovative contribution towards optimizing healthcare provision for MS patients in Germany.