There is a high prevalence of SWCD in CHI patients admitted to a brain injury rehabilitation unit. Patients with SWCD have longer stays in both acute and rehabilitation settings and may be a marker for more severe injury.

Multiple sclerosis (MS) is a disabling immune-mediated disease of the CNS and considered one of the health conditions with the highest annual spending growth paid by both public and private insurance. 1 Health care spending in the United States for MS was reported as $13.9 billion in 2016. 1 The estimated cumulated (over 10 years) prevalence of MS among adults in the United States in 2010 was approximately 727,000. 2 In 2017, that number was substantially higher, approximately 914,000. 2,3 The prevalence is higher among women, with a female: male ratio of 2.8. 2 Improving high-quality care for these patients can lead to improved outcomes, reduced spending, and better quality of life.The American Academy of Neurology Institute (AANI) released the original MS quality measurement set in 2015, aimed at improving the delivery of care and outcomes for patients with MS. 4 The AANI measure development process requires a triennial review of measures to confirm whether evidence remains current, a gap in care remains for measurement, and response to any measure implementation and testing data. 5 A standing multidisciplinary MS quality measurement work group was seated for a 2-year term to conduct an initial review of evidence and to be available for the development of quality improvement and implementation tools. 5 The work group members are also responsible for reviewing MS quality measure data from the AANI's quality improvement registry: the Axon Registry. 6 MethodsDetails of the AANI's full measure development process are available online. 5 A call for multidisciplinary work group members was made to representative neurologists, patients, and advocates. The application process was managed by 2 nonvoting facilitator methodologists seated from the AANI's Quality Measurement Subcommittee and Quality Committee. Applicant subject matter expertise and measure development experience was reviewed in conjunction with review of disclosure statements to select the work group members. 5 The AANI measure development process requires disclosure of industry relationships and other entities to avoid actual, potential, or perceived conflicts of interest. 5 Work group members were instructed to abstain from voting on individual measure concepts if a conflict was present. 5 An initial literature search was conducted with the help of a medical librarian and resulted in 1,974 abstracts identified from EMBASE and MEDLINE. The literature search results were winnowed to 356 articles. These articles included potential guidelines, systematic reviews, meta-analyses, articles containing evidence of gaps in care for patients with MS, or articles summarizing patient and care partner preferences. The work group also reviewed performance data from Axon Registry and Axon Registry participant data to determine whether measures