% 0期刊文章%安德鲁·j·所罗门%露丝尚Viswanathan安·上% %一个梅林达Magyari Jorge Correale % %尼尔·p·罗伯逊%一个迪安娜·R·塞勒%温迪Kaye %一个Eunchan Bae林赛Rechtman % % %雷切尔国王罗素Shinohara %乔安娜Laurson-Doube %安妮·赫尔姆% T全球障碍的诊断多发性硬化症% B多发性硬化症国际联合会的数据阿特拉斯女士,第三版% D R 10.1212 / WNL 2023%。0000000000207481 % J首页神经病学% P e624-e635 % V 101% N 6% X背景和目标最近的数据表明增加全球流行的多发性硬化症(MS)。早期诊断的MS减少残疾调整生命年的负担和相关医疗费用。然而诊断延误坚持照顾女士,即使在国家卫生保健系统和强大的资源,全面登记,女士subspecialist转诊网络。全球患病率和加速女士障碍诊断的特点,尤其是在resource-restricted地区,并没有被广泛地研究过了。最近修正MS诊断标准展示潜力促进早期诊断,但全球实现在很大程度上仍是个未知数。方法多发性硬化症国际联合会第三版的阿特拉斯女士是一个调查,评估当前的全局状态的诊断包括采用MS诊断标准;障碍诊断的病人,卫生保健提供者,和卫生系统;和存在的国家指导方针或国家标准速度的诊断。结果来自107个国家的协调员(约占世界人口的82%),参与。百分之八十三至少1“主要障碍”女士早期诊断。 The most frequently reported barriers included the following: “lack of awareness of MS symptoms among general public” (68%), “lack of awareness of MS symptoms among health care professionals” (59%), and “lack of availability of health care professionals with knowledge to diagnose MS” (44%). One-third reported lack of “specialist medical equipment or diagnostic tests.” Thirty-four percent reported the use of only 2017 McDonald criteria (McD-C) for diagnosis, and 79% reported 2017 McD-C as the “most commonly used criteria.” Sixty-six percent reported at least 1 barrier to the adoption of 2017 McD-C, including “neurologists lack awareness or training” by 45%. There was no significant association between national guidelines pertaining to MS diagnosis or practice standards addressing the speed of diagnosis and presence of barriers to early MS diagnosis and implementation of 2017 McD-C.Discussion This study finds pervasive consistent global barriers to early diagnosis of MS. While these barriers reflected a lack of resources in many countries, data also suggest that interventions designed to develop and implement accessible education and training can provide cost-effective opportunities to improve access to early MS diagnosis.GOF=Goodness of Fit; McD-C=McDonald criteria; MS=multiple sclerosis; MSIF=Multiple Sclerosis International Federation; OR=odds ratio; WB=World Bank; WHO=World Health Organization %U //www.ez-admanager.com/content/neurology/101/6/e624.full.pdf
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