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参与一项研究登记的多发性硬化症患者报告症状的诊断延迟和误诊情况。

Diagnostic delay and misdiagnosis of symptoms reported by patients with multiple sclerosis participating in a research registry.

作者信息

Solomon Andrew J, Weinstein Sarah M, Shinohara Russell T, Aoun Samar M, Schmidt Hollie, Solari Alessandra

机构信息

Larner College of Medicine at the University of Vermont, Department of Neurological Sciences, Burlington, VT, USA.

Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadelphia, PA, USA.

出版信息

Mult Scler J Exp Transl Clin. 2025 Apr 17;11(2):20552173251333390. doi: 10.1177/20552173251333390. eCollection 2025 Apr-Jun.

Abstract

BACKGROUND

Research cohort data suggest diagnostic delay in multiple sclerosis (MS) has diminished in tandem with MS diagnostic criteria revisions, yet other studies have not replicated this finding. Recent data indicate misdiagnosis of initial symptoms of MS is a frequent contributor to diagnostic delay.

OBJECTIVES

This survey study assessed diagnostic delay and misdiagnosis in an MS patient registry.

METHODS

Participants completed the survey study between November 12, 2021, through December 22, 2021.

RESULTS

There were 428 participants. Diagnostic delay was a median of 2.0 months (mean of 22.8 months, range: 0-32.9 years); 173/428 (40.4%) reported misdiagnosis of symptoms later attributed to MS, and this was associated with longer diagnostic delay ( < 0.001). Diagnostic delay decreased over time proximal to revisions to MS diagnostic criteria. 217/428 (50.7%) reported earlier symptoms retrospectively recognized as referable to MS that were not clinically evaluated, resulting in a diagnostic delay median of 5.4 years (mean 8.9 years, range: 0-47.4 years).

CONCLUSIONS

Diagnostic delay was prevalent and associated with frequent misdiagnosis of initial symptoms of MS and earlier unevaluated symptoms later attributed to MS. Studies tracing the diagnostic journey of patients with MS are needed to understand and prevent causes of diagnostic delay.

摘要

背景

研究队列数据表明,随着多发性硬化症(MS)诊断标准的修订,MS的诊断延迟有所减少,但其他研究并未重复这一发现。最近的数据表明,MS初始症状的误诊是导致诊断延迟的常见原因。

目的

本调查研究评估了一个MS患者登记处的诊断延迟和误诊情况。

方法

参与者于2021年11月12日至2021年12月22日期间完成了该调查研究。

结果

共有428名参与者。诊断延迟的中位数为2.0个月(平均22.8个月,范围:0至32.9年);173/428(40.4%)报告称,后来被归因于MS的症状曾被误诊,这与更长的诊断延迟相关(<0.001)。在接近MS诊断标准修订时,诊断延迟随时间减少。217/428(50.7%)报告称,回顾性地认为可归因于MS的早期症状未得到临床评估,导致诊断延迟的中位数为5.4年(平均8.9年,范围:0至47.4年)。

结论

诊断延迟很普遍,且与MS初始症状的频繁误诊以及后来被归因于MS的早期未评估症状相关。需要开展追踪MS患者诊断过程的研究,以了解和预防诊断延迟的原因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/989c/12033781/d1df9ebced9a/10.1177_20552173251333390-fig1.jpg

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