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放射学孤立综合征诊断前的医疗保健利用情况分析。

Analysis of healthcare utilization before the diagnosis of radiologically isolated syndrome.

作者信息

Lebrun-Frenay Christine, Kerbrat Sandrine, Okuda Darin T, Landes-Chateau Cassandre, Kantarci Orhun H, Pierret Chloe, Drezen Erwan, Nowak Emmanuel, Siva Aksel, Azevedo Christina J, Cohen Mikael, Leray Emmanuelle

机构信息

CRCSEP Neurology, CHU Nice, UR2CA-URRIS, Université Nice Cote d'Azur, Hôpital Pasteur, Nice, France; CRCSEP Nice, Neurologie CHU de Nice Pasteur 2, Nice, France.

DAMAD Plouzané, Plouzané, France.

出版信息

Mult Scler. 2025 Feb;31(2):184-196. doi: 10.1177/13524585241291471. Epub 2025 Jan 10.

Abstract

BACKGROUND

Previous studies have shown that people with multiple sclerosis (MS) had frequent healthcare visits up to 10 years before being diagnosed but with no information from magnetic resonance imaging (MRI) scans of the connection with the radiologically isolated syndrome (RIS).

OBJECTIVE

To analyze healthcare use 3 years before the RIS diagnosis.

METHODS

We examined healthcare usage before the first scan in RIS cases from 2010 to 2019. RIS subjects were identified from the French National MS observatory and compared to the general population (matched 10:1) and MS patients (matched 4:1).

RESULTS

Among 482 RIS individuals, 223 (46.3%) were not linked to the healthcare resources database. The remaining RIS individuals (53.7%) had higher healthcare usage before their RIS diagnosis for issues related to neurology visits, headaches (odds ratio (OR): 3.34, confidence interval (CI): [2.00-5.57], < 0.0001), and the use of anti-migraine drugs (OR: 2.61, CI: [1.37-4.99], = 0.004) compared to MS.

CONCLUSION

Only about half of RIS patients had MS-selected healthcare resources, which allowed for data linkage. Those who did seek care before their RIS diagnosis were most commonly known for other neurological comorbidities. These findings do not support the idea of a systemic prodrome before RIS diagnosis.

摘要

背景

先前的研究表明,患有多发性硬化症(MS)的人在被诊断前长达10年经常就医,但没有关于磁共振成像(MRI)扫描与放射学孤立综合征(RIS)之间联系的信息。

目的

分析RIS诊断前3年的医疗保健使用情况。

方法

我们检查了2010年至2019年RIS病例首次扫描前的医疗保健使用情况。从法国国家MS观察站识别出RIS受试者,并与普通人群(匹配比例为10:1)和MS患者(匹配比例为4:1)进行比较。

结果

在482名RIS个体中,223名(46.3%)未与医疗资源数据库相关联。其余的RIS个体(53.7%)在RIS诊断前因与神经科就诊、头痛相关的问题(优势比(OR):3.34,置信区间(CI):[2.00 - 5.57],<0.0001)以及使用抗偏头痛药物(OR:2.61,CI:[1.37 - 4.99],=0.004)而有更高的医疗保健使用率,与MS患者相比。

结论

只有约一半的RIS患者拥有可供数据关联的MS相关医疗资源。那些在RIS诊断前确实寻求治疗的患者最常见的是患有其他神经科合并症。这些发现不支持RIS诊断前存在系统性前驱症状的观点。

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