Wolfgang Emanuel Zürrer, Amelia Elaine Cannon, Dariya Ilchenko, María Inés Gaitán, Tobias Granberg, Fredrik Piehl, Andrew J Solomon, Benjamin Victor Ineichen
{"title":"多发性硬化症的误诊和漏诊:系统回顾和荟萃分析。","authors":"Wolfgang Emanuel Zürrer, Amelia Elaine Cannon, Dariya Ilchenko, María Inés Gaitán, Tobias Granberg, Fredrik Piehl, Andrew J Solomon, Benjamin Victor Ineichen","doi":"10.1177/13524585241274527","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Diagnostic errors in multiple sclerosis (MS) impact patients and healthcare systems.</p><p><strong>Objectives: </strong>This study aimed to determine the prevalence of MS misdiagnosis and underdiagnosis, time delay in reaching a correct diagnosis and potential impact of sex.</p><p><strong>Methods: </strong>Systematic review and meta-analysis on MS diagnostic errors.</p><p><strong>Results: </strong>Out of 3910 studies, we included 62 for a qualitative synthesis and 24 for meta-analyses. Frequency of misdiagnosis (incorrect assignment of an MS diagnosis) ranged from 5% to 41%, with a pooled proportion based on six studies of 15% (95% CI: 9%-26%, <i>n</i> = 1621). The delay to rectify a misdiagnosis ranged from 0.3 to 15.9 years. Conversely, underdiagnosis (unrecognized diagnosis of MS) ranged from 3% to 58%, with a pooled proportion in four studies of 36% (95% CI: 20%-55%, <i>n</i> = 728). Pooling seven studies comprising 2851 individuals suggested a diagnostic delay to establish a correct MS diagnosis of 17.3 months (95% CI: 11.9-22.7) in patients underdiagnosed. In a meta-analysis of five studies, women were 2.1 times more likely to be misdiagnosed with MS compared to men (odds ratio, 95% CI: 1.53-2.86).</p><p><strong>Conclusion: </strong>This study provides summary-level evidence for the high prevalence of MS misdiagnosis and underdiagnosis. Future studies are needed to understand the causes of these diagnostic challenges in MS care.</p>","PeriodicalId":18874,"journal":{"name":"Multiple Sclerosis Journal","volume":null,"pages":null},"PeriodicalIF":4.8000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Misdiagnosis and underdiagnosis of multiple sclerosis: A systematic review and meta-analysis.\",\"authors\":\"Wolfgang Emanuel Zürrer, Amelia Elaine Cannon, Dariya Ilchenko, María Inés Gaitán, Tobias Granberg, Fredrik Piehl, Andrew J Solomon, Benjamin Victor Ineichen\",\"doi\":\"10.1177/13524585241274527\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Diagnostic errors in multiple sclerosis (MS) impact patients and healthcare systems.</p><p><strong>Objectives: </strong>This study aimed to determine the prevalence of MS misdiagnosis and underdiagnosis, time delay in reaching a correct diagnosis and potential impact of sex.</p><p><strong>Methods: </strong>Systematic review and meta-analysis on MS diagnostic errors.</p><p><strong>Results: </strong>Out of 3910 studies, we included 62 for a qualitative synthesis and 24 for meta-analyses. Frequency of misdiagnosis (incorrect assignment of an MS diagnosis) ranged from 5% to 41%, with a pooled proportion based on six studies of 15% (95% CI: 9%-26%, <i>n</i> = 1621). The delay to rectify a misdiagnosis ranged from 0.3 to 15.9 years. Conversely, underdiagnosis (unrecognized diagnosis of MS) ranged from 3% to 58%, with a pooled proportion in four studies of 36% (95% CI: 20%-55%, <i>n</i> = 728). Pooling seven studies comprising 2851 individuals suggested a diagnostic delay to establish a correct MS diagnosis of 17.3 months (95% CI: 11.9-22.7) in patients underdiagnosed. In a meta-analysis of five studies, women were 2.1 times more likely to be misdiagnosed with MS compared to men (odds ratio, 95% CI: 1.53-2.86).</p><p><strong>Conclusion: </strong>This study provides summary-level evidence for the high prevalence of MS misdiagnosis and underdiagnosis. 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Misdiagnosis and underdiagnosis of multiple sclerosis: A systematic review and meta-analysis.
Background: Diagnostic errors in multiple sclerosis (MS) impact patients and healthcare systems.
Objectives: This study aimed to determine the prevalence of MS misdiagnosis and underdiagnosis, time delay in reaching a correct diagnosis and potential impact of sex.
Methods: Systematic review and meta-analysis on MS diagnostic errors.
Results: Out of 3910 studies, we included 62 for a qualitative synthesis and 24 for meta-analyses. Frequency of misdiagnosis (incorrect assignment of an MS diagnosis) ranged from 5% to 41%, with a pooled proportion based on six studies of 15% (95% CI: 9%-26%, n = 1621). The delay to rectify a misdiagnosis ranged from 0.3 to 15.9 years. Conversely, underdiagnosis (unrecognized diagnosis of MS) ranged from 3% to 58%, with a pooled proportion in four studies of 36% (95% CI: 20%-55%, n = 728). Pooling seven studies comprising 2851 individuals suggested a diagnostic delay to establish a correct MS diagnosis of 17.3 months (95% CI: 11.9-22.7) in patients underdiagnosed. In a meta-analysis of five studies, women were 2.1 times more likely to be misdiagnosed with MS compared to men (odds ratio, 95% CI: 1.53-2.86).
Conclusion: This study provides summary-level evidence for the high prevalence of MS misdiagnosis and underdiagnosis. Future studies are needed to understand the causes of these diagnostic challenges in MS care.
期刊介绍:
Multiple Sclerosis Journal is a peer-reviewed international journal that focuses on all aspects of multiple sclerosis, neuromyelitis optica and other related autoimmune diseases of the central nervous system.
The journal for your research in the following areas:
* __Biologic basis:__ pathology, myelin biology, pathophysiology of the blood/brain barrier, axo-glial pathobiology, remyelination, virology and microbiome, immunology, proteomics
* __Epidemology and genetics:__ genetics epigenetics, epidemiology
* __Clinical and Neuroimaging:__ clinical neurology, biomarkers, neuroimaging and clinical outcome measures
* __Therapeutics and rehabilitation:__ therapeutics, rehabilitation, psychology, neuroplasticity, neuroprotection, and systematic management
Print ISSN: 1352-4585