Heesen C, Schäffler N, Kasper J, Mühlhauser I, Köpke S
Institute of Neuroimmunology and Clinical MS Research (inims), University Medical Center Hamburg-Eppendorf, Martinistrasse, Hamburg, Germany.
Mult Scler. 2009 Sep;15(9):1103-12. doi: 10.1177/1352458509106508. Epub 2009 Jul 22.
Parallel to the establishment of early treatments in multiple sclerosis (MS), new diagnostic criteria have made an earlier diagnosis possible. While there is ongoing discussion about possible benign courses and only partial effective treatments, there have been no attempts today to facilitate shared decision making on diagnostic testing between patients with suspected MS and their physicians.
This study describes the development and validation process of a leaflet to be presented to people with suspected MS to engage them in a diagnostic decision-making process.
After a qualitative study showing acceptability among five patients, the leaflet was presented to a retrospective cohort (n = 87 of which 70 replied)) of patients being diagnosed within the last 2 years as well to a prospective cohort of n = 51 patients with symptoms suggestive of MS.
Approximately 70% of patients in the prospective as well as in the retrospective cohort wanted to be informed about a possible MS before testing, whereas 10% did not. The leaflet did not seem to elicit anxieties. The attitude to undergo diagnostic testing was not influenced by the leaflet, which can be explained by the nonexperimental design of the study.
Taken together, our findings demonstrate that early information about possible MS is warranted by patients and does not show negative side effects. Further studies on evidence-based patient information in early MS seem necessary.
在多发性硬化症(MS)早期治疗方法确立的同时,新的诊断标准使更早诊断成为可能。尽管对于可能的良性病程以及仅部分有效的治疗方法仍在进行讨论,但目前尚未尝试促进疑似MS患者与其医生之间就诊断检测进行共同决策。
本研究描述了一份宣传册的开发和验证过程,该宣传册将提供给疑似MS患者,以使他们参与诊断决策过程。
在一项定性研究显示五名患者能够接受该宣传册后,将其提供给一个回顾性队列(n = 87,其中70人回复),这些患者在过去两年内被诊断,同时也提供给一个前瞻性队列,n = 51名有MS症状提示的患者。
前瞻性队列和回顾性队列中约70%的患者希望在检测前了解是否可能患有MS,而10%的患者不希望。该宣传册似乎并未引发焦虑情绪。接受诊断检测的态度不受宣传册影响,这可以通过该研究的非实验设计来解释。
总体而言,我们的研究结果表明患者需要关于可能患有MS的早期信息,且未显示出负面副作用。似乎有必要对MS早期基于证据的患者信息进行进一步研究。