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Multiple Sclerosis => MS - RESEARCH AND NEWS => Topic started by: agate on September 01, 2016, 03:01:46 pm

Title: MS misdiagnosis study favors improved education of clinicians
Post by: agate on September 01, 2016, 03:01:46 pm
A number of authorities in the world of MS research have come out with an article strongly favoring better training of clinicians in the diagnosis of MS because so many people have been misdiagnosed with MS--and treated for it:

From Neurology, August 31, 2016:

Quote
The contemporary spectrum of multiple sclerosis misdiagnosis--
A multicenter study

Andrew J. Solomon, MD, Dennis N. Bourdette, MD, Anne H. Cross, MD, Angela Applebee, MD, Philip M. Skidd, MD, Diantha B. Howard, MA, Rebecca I. Spain, MD, Michelle H. Cameron, MD, Edward Kim, MD, Michele K. Mass, MD, Vijayshree Yadav, MD, Ruth H. Whitham, MD, Erin E. Longbrake, MD, PhD, Robert T. Naismith, MD, Gregory F. Wu, MD, PhD, Becky J. Parks, MD, Dean M. Wingerchuk, MD, Brian L. Rabin, MD, Michel Toledano, MD, W. Oliver Tobin, MBBCh, PhD, Orhun H. Kantarci, MD, Jonathan L. Carter, MD, B. Mark Keegan, MD and Brian G. Weinshenker, MD

AUTHOR AFFILIATIONS:

From the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN.

Correspondence to Dr. Solomon: andrew.solomon@uvm.edu



Objective:

To characterize patients misdiagnosed with multiple sclerosis (MS).

Methods:

 Neurologists at 4 academic MS centers submitted data on patients determined to have been misdiagnosed with MS.

Results:

Of 110 misdiagnosed patients, 51 (46%) were classified as “definite” and 59 (54%) “probable” misdiagnoses according to study definitions. Alternate diagnoses included migraine alone or in combination with other diagnoses 24 (22%), fibromyalgia 16 (15%), nonspecific or nonlocalizing neurologic symptoms with abnormal MRI 13 (12%), conversion or psychogenic disorders 12 (11%), and neuromyelitis optica spectrum disorder 7 (6%).

Duration of misdiagnosis was 10 years or longer in 36 (33%) and an earlier opportunity to make a correct diagnosis was identified for 79 patients (72%).

Seventy-seven (70%) received disease-modifying therapy and 34 (31%) experienced unnecessary morbidity because of misdiagnosis. Four (4%) participated in a research study of an MS therapy.

Leading factors contributing to misdiagnosis were consideration of symptoms atypical for demyelinating disease, lack of corroborative objective evidence of a CNS lesion as satisfying criteria for MS attacks, and overreliance on MRI abnormalities in patients with nonspecific neurologic symptoms.

Conclusions:


Misdiagnosis of MS leads to unnecessary and potentially harmful risks to patients. Misinterpretation and misapplication of MS clinical and radiographic diagnostic criteria are important contemporary contributors to misdiagnosis.

The abstract can be seen here (http://www.neurology.org/content/early/2016/08/31/WNL.0000000000003152.short).

Medical News Today (September 1, 2016) has an article about this study,
"Multiple sclerosis misdiagnosis study supports improved education of clinicians" (http://www.medicalnewstoday.com/releases/312673.php).