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Diagnostic delay of multiple sclerosis: prevalence, determinants and consequences

BACKGROUND: Early diagnosis and treatment of patients with multiple sclerosis (MS) are associated with better outcomes; however, diagnostic delays remain a major problem. OBJECTIVE: Describe the prevalence, determinants and consequences of delayed diagnoses. METHODS: This single-centre ambispective...

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Detalles Bibliográficos
Autores principales: Uher, Tomas, Adzima, Adrian, Srpova, Barbora, Noskova, Libuse, Maréchal, Bénédicte, Maceski, Aleksandra Maleska, Krasensky, Jan, Stastna, Dominika, Andelova, Michaela, Novotna, Klara, Vodehnalova, Karolina, Motyl, Jiri, Friedova, Lucie, Lindner, Jiri, Ravano, Veronica, Burgetova, Andrea, Dusek, Petr, Fialova, Lenka, Havrdova, Eva Kubala, Horakova, Dana, Kober, Tobias, Kuhle, Jens, Vaneckova, Manuela
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10580682/
https://www.ncbi.nlm.nih.gov/pubmed/37840276
http://dx.doi.org/10.1177/13524585231197076
Descripción
Sumario:BACKGROUND: Early diagnosis and treatment of patients with multiple sclerosis (MS) are associated with better outcomes; however, diagnostic delays remain a major problem. OBJECTIVE: Describe the prevalence, determinants and consequences of delayed diagnoses. METHODS: 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. RESULTS: 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. CONCLUSION: Diagnostic delays in MS are common, often determined by early misdiagnosis and associated with greater disease burden.