Diagnostic delay of multiple sclerosis: prevalence, determinants and consequences.
Details
State: Public
Version: Final published version
License: CC BY-NC 4.0
Serval ID
serval:BIB_3610DFC00F46
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Diagnostic delay of multiple sclerosis: prevalence, determinants and consequences.
Journal
Multiple sclerosis
ISSN
1477-0970 (Electronic)
ISSN-L
1352-4585
Publication state
Published
Issued date
10/2023
Peer-reviewed
Oui
Volume
29
Number
11-12
Pages
1437-1451
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Abstract
Early diagnosis and treatment of patients with multiple sclerosis (MS) are associated with better outcomes; however, diagnostic delays remain a major problem.
Describe the prevalence, determinants and consequences of delayed diagnoses.
This single-centre ambispective study analysed 146 adult relapsing-remitting MS patients (2016-2021) for frequency and determinants of diagnostic delays and their associations with clinical, cognitive, imaging and biochemical measures.
Diagnostic delays were identified in 77 patients (52.7%), including 42 (28.7%) physician-dependent cases and 35 (24.0%) patient-dependent cases. Diagnosis was delayed in 22 (15.1%) patients because of misdiagnosis by a neurologist. A longer diagnostic delay was associated with trends towards greater Expanded Disability Status Scale (EDSS) scores (B = 0.03; p = 0.034) and greater z-score of the blood neurofilament light chain (B = 0.35; p = 0.031) at the time of diagnosis. Compared with patients diagnosed at their first clinical relapse, patients with a history of >1 relapse at diagnosis (n = 63; 43.2%) had a trend towards greater EDSS scores (B = 0.06; p = 0.006) and number of total (B = 0.13; p = 0.040) and periventricular (B = 0.06; p = 0.039) brain lesions.
Diagnostic delays in MS are common, often determined by early misdiagnosis and associated with greater disease burden.
Describe the prevalence, determinants and consequences of delayed diagnoses.
This single-centre ambispective study analysed 146 adult relapsing-remitting MS patients (2016-2021) for frequency and determinants of diagnostic delays and their associations with clinical, cognitive, imaging and biochemical measures.
Diagnostic delays were identified in 77 patients (52.7%), including 42 (28.7%) physician-dependent cases and 35 (24.0%) patient-dependent cases. Diagnosis was delayed in 22 (15.1%) patients because of misdiagnosis by a neurologist. A longer diagnostic delay was associated with trends towards greater Expanded Disability Status Scale (EDSS) scores (B = 0.03; p = 0.034) and greater z-score of the blood neurofilament light chain (B = 0.35; p = 0.031) at the time of diagnosis. Compared with patients diagnosed at their first clinical relapse, patients with a history of >1 relapse at diagnosis (n = 63; 43.2%) had a trend towards greater EDSS scores (B = 0.06; p = 0.006) and number of total (B = 0.13; p = 0.040) and periventricular (B = 0.06; p = 0.039) brain lesions.
Diagnostic delays in MS are common, often determined by early misdiagnosis and associated with greater disease burden.
Keywords
Adult, Humans, Multiple Sclerosis/diagnosis, Multiple Sclerosis/epidemiology, Multiple Sclerosis/pathology, Delayed Diagnosis, Prevalence, Multiple Sclerosis, Relapsing-Remitting/diagnosis, Multiple Sclerosis, Relapsing-Remitting/epidemiology, Multiple Sclerosis, Relapsing-Remitting/pathology, Recurrence, Magnetic Resonance Imaging, Brain/pathology, Delayed diagnosis, brain lesion, cerebrospinal fluid, disability, magnetic resonance imaging, misdiagnosis, multiple sclerosis, neurofilament
Pubmed
Web of science
Open Access
Yes
Create date
19/10/2023 16:25
Last modification date
09/02/2024 9:45