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Cited by 44Multiple Sclerosis Research StudiesClinical Reasoning and Diagnostic SkillsPeripheral Neuropathies and Disorders

Diagnostic Delay of Multiple Sclerosis in a Portuguese Population

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Aires, Ana, Barros, Ariana, Machado, Célia, Fitas, Diogo, Cação, Gonçalo, Pedrosa, Rui, Cerqueira, João, Perdigão, Sandra +4 more·2019·Acta Médica Portuguesa
DOI 10.20344/amp.11187
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Abstract

Introduction: Multiple sclerosis is a chronic inflammatory disease, in which a diagnostic delay could reduce the available therapeutic options. Therefore, it is important to monitor the time to diagnosis and understand factors that may potentially reduce it. The objective of this study was to determine the time between the first symptoms and the diagnosis of multiple sclerosis and which factors may contribute to a diagnostic delay.Material and Methods: Cross-sectional multicenter study, with retrospective data analysis, conducted in five tertiary Portuguese hospitals. Patients were consecutively selected from each local multiple sclerosis patients´ database. Sociodemographic and initial clinical data were collected through a questionnaire. Date of final diagnosis and multiple sclerosis classification was obtained from clinical files.Results: A total of 285 patients were included with mean age at diagnosis of 36 years. The median time between first clinical manifestation and multiple sclerosis diagnosis was nine months (IQR 2 - 38). Diagnostic delay was associated with an older age (p < 0.001; r = 0.35), motor deficit at onset [26.5 months (IQR 4.5 - 56.5); p = 0.0005], higher number of relapses before diagnosis (p < 0.001; r = 0,626), first observation by other medical specialty [11 months (IQR 2 - 48); p < 0.001], prior alternative diagnosis [20 months (IQR 4 - 67.5); p < 0.001] and primary progressive subtype [37 months (IQR 25 - 64.5); p < 0.001]. The most significant delay occurred between the initial symptom and neurological observation.Discussion: A significant delay occurred between initial symptoms and the diagnosis of multiple sclerosis, reflecting the need toincrease awareness of this entity and its diverse symptom presentation.

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  • In a 2019 Portuguese study, 30 (23%) of 128 patients with MS at five tertiary care centers had received psychiatric diagnoses prior to a diagnosis of MS.

    “In a 2019 study, 30 (23%) of 128 patients with MS at five tertiary care centers in Portugal had received psychiatric diagnoses prior to a diagnosis of MS [15].”

    From Functional neurological disorder and multiple sclerosis: a systematic review of misdiagnosis and clinical overlap (2022) · cites this paper as [15]

    Materials and Methods describes a study at five tertiary hospitals in Portugal, and Results reports that 128 of 285 patients had a prior alternative diagnosis. Results does not identify 30 of those 128 as having received psychiatric diagnoses; its 0.7% figure concerns initial psychiatric symptoms, not prior diagnoses. The claimed psychiatric-diagnosis count and percentage are therefore unsupported by our copy. (LLM, conf=0.86)

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Research works printed but not linked: 27

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Authors
Aires, A., Barros, A., Machado, C., Fitas, D., Cação, G., Pedrosa, R., Cerqueira, J., Perdigão, S., Silva, A. M. D., Vale, J., Sá, M. J., & Andrade, C.
Affiliations
  • Hospital de São João (PT)
  • Unidade Local de Saúde de São José (PT)
  • Hospital Braga (PT)
  • Unidade Local de Saúde do Alto Minho (PT)
  • Centro Hospitalar do Porto (PT)
  • Hospital Beatriz Ângelo (PT)
ORCID
Venue
Acta Médica Portuguesa
Publisher
Ordem dos Medicos
Published
2019-04-30
Volume
32
Issue
4
Pages
289-294
ISSN
  • 0870-399X (ISSN-L)
  • 1646-0758
DOI
10.20344/amp.11187
OpenAlex
W2947417492
Cited by
44
References
0
Citations by year
2026: 4 · 2025: 8 · 2024: 9 · 2023: 9 · 2022: 2 · 2021: 6 · 2020: 5 · 2019: 1
FWCI
2.57
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • Acta Médica Portuguesa (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, cc-by-nc)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, other-oa)
Funders
Biogen
Topics
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
  • Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
  • Health Sciences › Medicine › Neurology › Peripheral Neuropathies and Disorders
Keywords
multiple sclerosis, delayed diagnosis, time to diagnosis, age at diagnosis, alternative diagnoses, primary progressive multiple sclerosis, neurological referral, Portuguese patients
MeSH terms
Motor Disorders, Adult, Age Factors, Aged, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Multiple Sclerosis, Neurologic Examination, Portugal, Recurrence, Retrospective Studies, Time Factors, Disease Progression, Delayed Diagnosis

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