Bo C Bertilson

Bo Christer Bertilson

Affiliated to research

Research leader ME/CFS and Pain and Movement disorders
and Coordinator Academic Development

About me

I am a MD and a licensed sports medical physician. In 2009 I earned a PhD by defending my thesis "On the assessment of nerve involvement and of dysfunction in patients with spinal pain”. I now serve as research leader at the Medect Clinical Trials and Bragée pain clinic and of the Pain Inflammation and Fatigue (PIAF) network at Karolinska Institutet. https://kise.sharepoint.com/teams/GRP_PIAF

As a researcher, focus is on diagnostic methods and treatment of non-specific pain and dysfunction including ME/CFS, Fibromyalgia, IBS and similar dysfunctions that often develop after whiplash trauma. I am the writer/co-writer of about 20 referee reviewed and about 80 medical student/resident scientific publications. I have served as reviewer of scientific articles and PhD opponent and am presently coordinator of scientific development at Academic Primary Care Center and on the research board for NRH Trauma Riks. https://www.nrhtrauma.se/vetenskapligtrad/

As a teacher, I have given thousands of lectures/seminars/courses on subjects such as pain diagnostics, sports and orthopaedic medicine and health promotion, injection technique, research planning, and scientific writing and presentation. I presently supervise three PhD students and half a dozen medical students and resident physicians in their scientific work.

As a physician I have conducted more than 100.000 patient visits and served as National Team physician to the Handball and Track and Field Associations. Also as medical advisor to several patient organisations, to the Swedish Social Insurance Agency central office in Stockholm and on several regional and national boards tasked with reports and guidelines on the care of patients with pain, for example "Nationellt uppdrag - Smärta". https://webbutik.skr.se/sv/artiklar/nationellt-uppdrag-smarta.html  

In 2002 I wrote the book "Att diagnostisera kluriga fall" (To Diagnose Tricky Cases") which has been used at KI and other medical universities. The book is, by request, being translated to english. To further the diagnostic accuracy and effective care of patients with "non-specific pain and dysfunction" I have, in cooperation, with dedicated colleagues developed a digital application named "Paint IT" and Artificial Intelligence (AI) algorithms to assess patient made discomfort (pain) drawings.

 

 

Research description

My current main scientific activity relates to non-specific pain and dysfunction such as head, neck- and back pain, Myalgic Encephalomyelitis /Chronic Fatigue Syndrome (ME/CFS), Fibromyalgia (FM), irritable bowel system (IBS) and other often overlapping symptoms.

The overall aim is to better understand pathophysiology and develop more effective care of these health problems that constitute 30-40 % of diagnoses in primary care (VAL 2017). Based on the diagnostic methods I assessed in my PhD studies I have continued to use, refine and add to these methods in cooperation with leading experts from different parts of the world including the Nordic countries, Great Britain and the US (Harvard and Stanford Universities) and a large number of students. The network I have been privileged to help develop is called PIAF, indicating “Pain Inflammation and Fatigue”. Within the network we have daily discussions and once a month an open (international) meeting in which we present and discuss the latest research. To the monthly meeting I invite selected researchers to share and discuss their knowledge and hypothesis, please see https://kise.sharepoint.com/teams/GRP_PIAF

In the PIAF research network I serve as main supervisor for three PhD students who recently passed the half-time review, all three with focus on pain diagnostics and management. Four other primary care clinicians have entered and completed the VR founded Primary care research school at KI with my help and presently I am main supervisor of 5 research projects by residents and medical students. In the last 6 months we have started 2 new research projects on ME/CFS and Covid 19 where I act as chair or coordinator.

A unique database on above 6000 patients with ME/CFS, chronic pain and/or exertion syndrome has been developed at the Bragée clinics in Stockholm since I accepted a part time position as research leader there in 2018. The database is to our knowledge, by far, the world’s largest database on patients with ME/CFS and the like. It contains clinical, radiological and laboratory data and more than 40 validated questionaries filled out at different times during the assessment process of the patients referred to the clinic from all of Sweden. The database has been developed in cooperation with statistic and logistic experts and relevant patient organisation representatives and contains millions of easily accessed datapoints. The cost for the work has been covered by Medect clinical trials. I have presented our database to government officials, the National Board of Health and Welfare and the Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) in several meetings with the purpose to invite other clinics to register and broaden it to become a national register.

August 2020 we published an article in Frontiers Neurology (a highly ranked journal in the field of neurology) based on data from the first 200+ patients in our ME/CSF cohort. In the article we present a new hypothesis on a possible pathological pathway to ME/CFS, FM, widespread pain and fatigue. Within a couple of months after publication the article became the most viewed article in the history of Frontiers Neurology. By Mars 2021, the article had > 33.000 views. https://www.frontiersin.org/articles/10.3389/fneur.2020.00828/full           

Our findings have contributed to the initiation of a new internet based international research group where hypothesis and research collaboration opportunities has developed, the MECFSbrainspine@groups.io.

In addition to the PIAF research network and the MECFSbrainspine network I serve as medical advisor to a number of patient organisations and on the research board for NRH Trauma Riks with the aim to support research and education on the effects, diagnostic and treatment methods of injuries to the head neck and spine. https://www.nrhtrauma.se/vetenskapligtrad/ In this position I have been the NRH representative to inform about and propose national strategies to government representatives including the Minister of Social Affairs.   

 

Scientific publications, referee reviewed in chronologic order

Bertilson BC, Grunnesjö M, Strender LE. Reliability of clinical tests in the assessment of patients with neck/shoulder problems – impact of history. Spine. 2003 Oct 1;28(19):2222-31          

PMID: 14520035 DOI: 10.1097/01.BRS.0000089685.55629.2E

https://insights-ovid-com.proxy.kib.ki.se/pubmed?pmid=14520035

 

Bertilson BC, Bring J, Sjöblom A, Sundell K, Strender LE. Inter-examiner reliability in the assessment of low back pain (LBP) using the Kirkaldy-Willis Classification (KWC). Eur Spine J. 2006 Nov;15(11):1695-703

PMID: 16435110 DOI: 10.1007/s00586-005-0050-3

https://link.springer.com/article/10.1007%2Fs00586-005-0050-3

 

Bertilson BC, Grunnesjö M, Johansson SE, Strender LE. Pain drawing in the assessment of neurogenic pain and dysfunction in the neck/shoulder region: inter-examiner reliability and concordance with clinical examination. Pain Med. 2007 Mar;8(2):134-46

PMID: 17305685 DOI: 10.1111/j.1526-4637.2006.00145.x

https://academic.oup.com/painmedicine/article/8/2/134/1847313

 

Bertilson BC, Brosjö E, Billing H, Strender LE. Assessment of nerve involvement in the lumbar spine: agreement between magnetic resonance imaging, physical examination and pain drawing findings. BMC Musculoskelet Disord. 2010 Sep 10;11:202

PMID: 20831785 PMCID: PMC2944219 DOI: 10.1186/1471-2474-11-202

https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/1471-2474-11-202

 

Bertilson BC, Claesson A, Claesson C, Sjövald E. Correlation of MRI findings of intervertebral disc water content and disc height with self-rated quality of life, pain, and disability. British Journal of Medicine and Medical Research. 2014 Feb 22;4(14):2639-2652

DOI:10.9734/BJMMR/2014/7345

http://www.journalrepository.org/media/journals/BJMMR_12/2014/Feb/Bertilson4142013BJMMR7345_1.pdf

 

Bertilson BC, Heidermark A, Stockhaus M. Irritable bowel syndrome – a neurological spine problem? British Journal of Medicine and Medical Research. 2014 May 29;4(24):4154-4168

DOI : 10.9734/BJMMR/2014/9746

https://pdfs.semanticscholar.org/d5b4/43630661371b745e1793a0581214e78fa476.pdf

 

Nawaz H, Umer M, Noordin S, Bertilson BC, Li J, Ahmed AS, Ahmed M. Synovial Neuronal Changes in Knee Joint Osteoarthritis. Open Journal of Rheumatology and Autoimmune Diseases. 2016 May 27; 6(2):26-33

http://www.scirp.org/journal/paperinformation.aspx?paperid=66855

 

Bernhoff G, Landén Ludvigsson M, Peterson G, Bertilson BC, Elf M, Peolsson A. The pain drawing as an instrument for identifying cervical spine nerve involvement in chronic whiplash-associated disorders. Journal of Pain Research. 2016 May 30;9(1):397-404

PMID: 27358576 PMCID: PMC4912326 DOI: 10.2147/JPR.S104747

https://www.dovepress.com/the-pain-drawing-as-an-instrument-for-identifying-cervical-spine-nerve-peer-reviewed-article-JPR

 

Zhang C, Kjellström H, Ek CH, Bertilson BC. Diagnostic Prediction Using Discomfort Drawing with IBTM, JMLR W&C Track Volume 56, Proceedings of Machine Learning for Healthcare 2016

http://proceedings.mlr.press/v56/Zhang16.html

 

Zhang C, Kjellström H, Bertilson BC. Diagnostic Prediction Using Discomfort Drawings. NIPS 2016 Workshop on Machine Learning for Health, arXiv:1612.01356

https://arxiv.org/abs/1607.08206

 

Olsson JE, Wallentin FY, Toth-Pal E, Ekblad S, Bertilson BC. Psychometric analysis of the Swedish version of the General Medical Council's multi source feedback questionnaires. International Journal of Medical Education. 2017 Oct 07;8:252-261

PMID: 28704204 PMCID: PMC5511742 DOI: 10.5116/ijme.5948.0bb6

https://www.ijme.net/archive/8/validation-of-the-swedish-version-of-the-gmc-questionnaire/?ref=linkout

 

Klasson M, Zhang K, Bertilson BC, Zhang C, Kjellström H. Causality Refined Diagnostic Prediction. NIPS ML4H 2017

https://arxiv.org/abs/1711.10915

 

Olsson JE, Ekblad S, Bertilson BC, Toth-Pal E. Swedish adaptation of the General Medical Council's multisource feedback questionnaires: a qualitative study. International Journal of Medical Education. 2018 June 15; 9:161–169

PMID: 29908128 PMCID: PMC6129165 DOI: 10.5116/ijme.5af6.c209

https://www.ijme.net/archive/9/swedish-adaptation-of-the-gmc-questionnaires/?ref=linkout

 

Olofsson H, Carlsson L, Bertilson BC. Multimorbidity among Patients with Back Pain. A Study of Records at a Swedish Primary Health Care Centre. J Family Med Prim Care: Open Acc. 2018 July 23; 118

DOI: 10.29011/JFOA-118. 100018

https://www.gavinpublishers.com/articles/Research-Article/Family-Medicine-and-Primary-Care-Open-Access/Multimorbidity-among-Patients-with-Back-Pain-A-Study-of-Records-at-a-Swedish-Primary-Health-Care-Centre

Citation: Olofsson H, Carlsson L, Bertilson BC (2018) Multimorbidity among Patients with Back Pain: A Study of Records at a Swedish Primary Health Care Centre. J Family Med Prim Care Open Acc 2: 118. DOI: 10.29011/2688-7460.100018

 

Ekblad S, Reventlid M, Lönnborg J, Bertilson BC. Three Interrelated Experiences to Live with Chronic Pain - A Qualitative Pilot Study with a Group of Patients with Refugee Status in Swedish Primary Care. EC Psychology and Psychiatry. 2018 Oct 31; 7(11): 896-903

https://www.ecronicon.com/ecpp/pdf/ECPP-07-00355.pdf

 

Patomella, AH, Mickols G, Asaba E, Nilsson G, Fridén C, Kottorp A, Bertilson BC, Tham K. General practitioners’ reasoning on risk screening and primary prevention of stroke – a focus group study.  BMC Family Practice. 2018 Dec 4; 19(1)

PMID: 30514217 PMCID: PMC6278124 DOI: 10.1186/s12875-018-0883-6

https://bmcfampract.biomedcentral.com/articles/10.1186/s12875-018-0883-6

 

Carlsson L, Olofsson H, Bertilson BC. Multimorbidity Patterns in Patients with Back Pain: A Study of Patient Records at a Primary Health Care Centre in Sweden. J Family Med Prim Care: Open Acc. 2019 Feb 21;3:126

DOI: 10.29011/JFOA-126/100026

https://www.gavinpublishers.com/articles/Research-Article/Family-Medicine-and-Primary-Care-Open-Access/multimorbidity-patterns-in-patients-with-back-pain-a-study-of-patient-records-at-a-primary-health-care-centre-in-sweden

Citation: Carlsson L, Olofsson H, Bertilson BC (2019) Multimorbidity Patterns in Patients with Back Pain: A Study of Patient Records at a Primary Health Care Centre in Sweden. J Family Med Prim Care Open Access 3: 126. DOI: 10.29011/2688-7460.100026

 

Bernhoff G, Saripanidis C, Bertilson BC. "As if neck injuries did not exist": An interview study of patients' and relatives' perceptions of web information on and management of whiplash injuries in Sweden. Interact J Med Res. 2019 May 21;8(2):e9881

PMID: 31115342 DOI: 10.2196/ijmr.9881

https://www.i-jmr.org/2019/2/e9881/

 

Tu R, Zhang K, Bertilson BC, Kjellström H, Zhang C. Neuropathic Pain Diagnosis Simulator for Causal Discovery Algorithm Evaluation. June 2019

https://arxiv.org/abs/1906.01732

 

Bragée B, Michos A, Drum B, Fahlgren M, Szulkin R, Bertilson BC. Signs of Intracranial Hypertension, Hypermobility and Craniocervical Obstructions in patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Front. Neurol. 11:828.doi: 10.3389/fneur.2020.  Published:28 August 2020

https://www.frontiersin.org/articles/10.3389/fneur.2020.00828/full

Preprint: https://osf.io/qwn5h/

 

Maria Flink, Ph.D.; Sebastian Lindblom; Malin Tistad, Ph.D.; Ann Charlotte Laska, Ph.D.; Bo Christer Bertilson, Ph.D.; Jan Hasselström, Ph.D.; Marie Elf, Ph.D.; Lena von Koch, Ph.D.; Charlotte Ytterberg, Ph.D. Person-centred care transitions for people with stroke: development and evaluation of a co-designed intervention. Submitted to NURL-D-19-01230

 

Ruibo Tu, Kun Zhang, Paul Ackermann, Bo Bertilson, Clark Glymour, Hedvig Kjellström, and Cheng Zhang. Causal discovery in the presence of missing data. Submitted to Journal of Machine Learning Research, Tue, 23 Jun 2020, preprint: https://arxiv.org/abs/1807.04010

 

 

 

Teaching portfolio

My teaching competence is primarily in the area of pain and orthopaedic assessment, including assessment of clinical and radiological findings. Secondly in teaching scientific planning and writing. My current teaching includes lectures, seminars and supervision of medical and PhD students and residents in their research projects.

Teaching is my favorite work. I believe it is the greatest calling, a privilege and an opportunity to improve and elevate mankind and society, or as Nelson Mandela said, “Education is the most powerful weapon which you can use to change the world”.

My teaching experience goes back to my time as a teenage scout leader, when “learning by doing” was the motto. Later, during medical school, I taught physics, biology, math and more to college students part-time. Since becoming a physician in the 1980s, I have spent thousands of hours preparing course and lesson material and teaching medicine to KI and Region Stockholm students and health professionals, mainly the subjects of pain, orthopaedics and sports medicine. Since the 1970s, I have also taught weekly in the community on healthy living, drugs, non-violence and spiritual and ethical topics to groups of 10 to a 1000 persons.

Since my dissertation in 2009 I have spent a total of about 1200 hours on active clinical and scientific teaching and about 800 hours supervising 1 to 3 medical students each semester. 

Education

Education and degrees: Degree in Medicine at Karolinska Institutet (KI), 1983 (M.D.); Registered physician in medicine, 1985; Specialist in Family Medicine, 1991; and Doctor of Medical Science (Ph.D.) at KI, 2009.

Academic honours, awards and prizes

1975              Top 5% grade point average, Brigham Young Univ. United States

1992-1994     Chairman, Stockholm Sports Medical Society

1995-2001     Team physician, National Handball and Track and Field Team

2000              Swedish Family Medicine Research Award by Astra

2000-2004     Expert government central insurance office in Stockholm for                              investigation of patients with whiplash/non-specific pain                                      dysfunction

2004-2006     Expert and primary care representative in Stockholm County                              Council work on medical programs for musculoskeletal                                      functions, pain, lumbar pain, rheumatism, and whiplash

2005              “Spine physician of the year”, Swedish Spine Association

2012-2014     Expert, National Board of Health and Welfare, Council for                                  radiology of the spine and chronic pain

2015-2016     Mentor4research scholarship recipient at The Royal Swedish                            Academy of Engineering Sciences for pain app innovation

2016-17         Expert and primary care representative in the national                                        collaborative committee for future directions in knowledge for                              “National assignment on pain”                                                                              https://webbutik.skr.se/bilder/artiklar/pdf/7585-444-1.pdf

2020-             Member, decision body, Stockholm Region Innovation Fund 

Highest ranked research article in Spine on reliability of physical examination tests used in the assessment of patients with shoulder problems according to systematic review 2010, “Reliability of physical examination tests used in the assessment of patients with shoulder problems: a systematic review”

Most viewed research article in Frontiers Neurology “Signs of Intracranial Hypertension, Hypermobility, and Craniocervical Obstructions in Patients With Myalgic Encephalomyelitis/Chronic Fatigue Syndrome”

http://loop-impact.frontiersin.org/impact/article/513006#totalviews/vie…

 

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