A Cross-Sectional Study of Delayed Diagnosis Associated with Gender and Racial Identity in Multiple Sclerosis.

BACKGROUND

Prior studies suggest a poorer prognosis in men and Black people with multiple sclerosis (pwMS). The possibility that delays in evaluation or diagnosis could contribute to worse outcomes remains underexplored. Our objective is to see if men or Black pwMS have delays in being evaluated for and diagnosed with multiple sclerosis (MS).

METHODS

This is an exploratory survey-based study of adult pwMS at our single institution center from 2019 to 2021. We surveyed patients to recall three events: their initial symptom onset, first neurology visit, and MS diagnosis.

RESULTS

Roughly equal numbers of analyzed respondents (total 245) self-identified as Black (50.2%) or White (49.8%), and 76.3% of respondents were women. There was no difference in mean age at symptom onset, first neurology visit, or MS diagnosis between Black and White pwMS, but men tended to be older at diagnosis (p = 0.08). There was a significantly increased median delay from symptom onset to MS diagnosis in men (16.5 months) vs. women (5 months, p = 0.015). Black pwMS had a greater delay of at least 6 months from symptom onset to first neurology visit compared to White pwMS (p = 0.03), though times from first neurology visit to MS diagnosis were similar.

CONCLUSIONS

Men had significant delays in being evaluated for and diagnosed with MS. Black pwMS were more likely to be delayed at least 6 months in being evaluated by a neurologist after symptom onset.