Carlos Karla, Prado Gilmar Fernandes do
Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia, Neuro-Sono, São Paulo SP, Brasil.
Arq Neuropsiquiatr. 2018 Dec;76(12):816-820. doi: 10.1590/0004-282X20180135.
In view of the diagnostic challenge posed by restless legs syndrome/Willis-Ekbom disease (RLS/WED) to health professionals and the challenge of its recognition by patients, the diagnostic criteria have been revised and updated to facilitate identification of this disease. However, in a previous study, we found that self-diagnosis of RLS/WED depends on the very name used to describe the condition. To ascertain whether the presence of the fifth diagnostic criterion of the International Restless Legs Syndrome Study Group (IRLSSG), is necessary for RLS/WED diagnosis when the term "Willis-Ekbom disease" is used.
We randomly distributed 705 forms to recent medical graduates, asking them to self-assess whether they had "Willis-Ekbom disease" (WED). In one questionnaire model, we excluded the fifth criterion suggested by the IRLSSG, while in the other, all five criteria were included. No forms contained the term RLS; only WED was used throughout.
Seven hundred and five recent medical graduates participated in the study. Among the 332 who received the form without the fifth criterion, 8 (2.41%) self-diagnosed as having WED (95%CI: 0.8%-4.1%). Of the 373 who received the form with all five of the 2014 IRLSSG criteria, 9 (2.41%) self-diagnosed as having WED (95%CI: 0.8%-4.0%) (p > 0.05).
Our data show that presence of the fifth IRLSSG criterion did not influence self-diagnosis of WED among recent medical graduates, suggesting that the name WED reduces the odds of mimics (confounding conditions) being misinterpreted as symptoms of this disease. This finding indicates that for the diagnosis of RLS/WED only four criteria and a systematic use of the name WED are necessary.
鉴于不宁腿综合征/Willis-Ekbom病(RLS/WED)给医疗专业人员带来的诊断挑战以及患者对其识别的挑战,已对诊断标准进行了修订和更新,以促进对该疾病的识别。然而,在之前的一项研究中,我们发现RLS/WED的自我诊断取决于用于描述该病症的名称。为了确定当使用“Willis-Ekbom病”一词时,国际不宁腿综合征研究组(IRLSSG)的第五条诊断标准对于RLS/WED诊断是否必要。
我们向近期医学毕业生随机分发了705份表格,要求他们自我评估是否患有“Willis-Ekbom病”(WED)。在一个问卷模型中,我们排除了IRLSSG建议的第五条标准,而在另一个模型中,纳入了所有五条标准。所有表格均未包含RLS一词;自始至终仅使用WED。
705名近期医学毕业生参与了该研究。在收到不含第五条标准表格的332人中,8人(2.41%)自我诊断为患有WED(95%置信区间:0.8%-4.1%)。在收到包含2014年IRLSSG所有五条标准表格的373人中,9人(2.41%)自我诊断为患有WED(95%置信区间:0.8%-4.0%)(p>0.05)。
我们的数据表明,IRLSSG的第五条标准的存在并未影响近期医学毕业生对WED的自我诊断,这表明WED这个名称降低了被误诊为该疾病症状的模仿病症(混淆病症)的几率。这一发现表明,对于RLS/WED的诊断,仅需要四条标准以及系统使用WED这个名称。