多发性硬化症的误诊和漏诊:系统回顾和荟萃分析。

IF 4.8 2区 医学 Q1 CLINICAL NEUROLOGY Multiple Sclerosis Journal Pub Date : 2024-10-01 Epub Date: 2024-09-08 DOI:10.1177/13524585241274527
Wolfgang Emanuel Zürrer, Amelia Elaine Cannon, Dariya Ilchenko, María Inés Gaitán, Tobias Granberg, Fredrik Piehl, Andrew J Solomon, Benjamin Victor Ineichen
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引用次数: 0

摘要

背景:多发性硬化症(MS)的诊断错误会影响患者和医疗系统:多发性硬化症(MS)的诊断错误会影响患者和医疗系统:本研究旨在确定多发性硬化症误诊和漏诊的发生率、获得正确诊断的时间延迟以及性别的潜在影响:方法:对多发性硬化症诊断错误进行系统回顾和荟萃分析:在 3910 项研究中,我们纳入了 62 项进行定性综合,24 项进行荟萃分析。误诊率(多发性硬化症诊断错误)从5%到41%不等,基于6项研究的汇总比例为15%(95% CI:9%-26%,n = 1621)。纠正误诊的延迟时间从 0.3 年到 15.9 年不等。相反,诊断不足(未被承认的多发性硬化症诊断)从3%到58%不等,四项研究的汇总比例为36%(95% CI:20%-55%,n = 728)。汇总七项研究(共 2851 人)表明,在诊断不足的患者中,MS 的正确诊断延迟时间为 17.3 个月(95% CI:11.9-22.7)。在对五项研究的荟萃分析中,女性被误诊为多发性硬化症的几率是男性的2.1倍(几率比,95% CI:1.53-2.86):本研究为多发性硬化症的高误诊率和低诊断率提供了简要证据。今后需要开展研究,以了解多发性硬化症护理中出现这些诊断难题的原因。
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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.

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来源期刊
Multiple Sclerosis Journal
Multiple Sclerosis Journal 医学-临床神经学
CiteScore
10.90
自引率
6.90%
发文量
186
审稿时长
3-8 weeks
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
期刊最新文献
Choroid plexus as a mediator of CNS inflammation in multiple sclerosis. Exploring the relationship between polycystic ovarian syndrome, testosterone, and multiple sclerosis in women: A nationwide cohort study and genome-wide cross-trait analysis. Impact of symptomatic multiple sclerosis therapy on pregnancy outcome. McArdle sign and neck flexion-induced change in central motor conduction in multiple sclerosis. How to avoid missing a diagnosis of neuromyelitis optica spectrum disorder.
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