TY - JOUR
T1 - Misdiagnosis in multiple sclerosis in a Brazilian reference center
T2 - Clinical, radiological, laboratory profile and failures in the diagnostic process—Cohort study
AU - Tieppo, Eduardo Macedo de Souza
AU - Silva, Guilherme Diogo
AU - Silva, Tomás Fraga Ferreira da
AU - Araujo, Roger Santana de
AU - Oliveira, Mateus Boaventura de
AU - Spricigo, Mariana Gondim Peixoto
AU - Pimentel, Gabriela Almeida
AU - Campana, Igor Gusmão
AU - Castrillo, Bruno Batitucci
AU - Mendes, Natalia Trombini
AU - Teixeira, Larissa Silva
AU - Nunes, Douglas Mendes
AU - Rimkus, Carolina de Medeiros
AU - Adoni, Tarso
AU - Apóstolos Pereira, Samira Luisa
AU - Callegaro, Dagoberto
N1 - Publisher Copyright: © The Author(s), 2023.
PY - 2023/12
Y1 - 2023/12
N2 - Background: Multiple sclerosis misdiagnosis remains a problem despite the well-validated McDonald 2017. For proper evaluation of errors in the diagnostic process that lead to misdiagnosis, it is adequate to incorporate patients who are already under regular follow-up at reference centers of demyelinating diseases. Objectives: To evaluate multiple sclerosis misdiagnosis in patients who are on follow-up at a reference center of demyelinating diseases in Brazil. Methods: We designed an observational study including patients in regular follow-up, who were diagnosed with multiple sclerosis at our specialized outpatient clinic in the Hospital of Clinics in the University of Sao Paulo, from 1996 to 2021, and were reassessed for misdiagnosis in 2022. We evaluated demographic information, clinical profile, and complementary exams and classified participants as “established multiple sclerosis,” “non-multiple sclerosis, diagnosed,” and “non-multiple sclerosis, undiagnosed.” Failures in the diagnostic process were assessed by the modified Diagnostic Error Evaluation and Research tool. Results: A total of 201 patients were included. After analysis, 191/201 (95.02%) participants were confirmed as “established multiple sclerosis,” 5/201 (2.49%) were defined as “non-multiple sclerosis, diagnosed,” and 5/201 (2.49%) were defined as “non-multiple sclerosis, undiagnosed.” Conclusions: Multiple sclerosis misdiagnosis persists in reference centers, emphasizing the need for careful interpretation of clinical findings to prevent errors.
AB - Background: Multiple sclerosis misdiagnosis remains a problem despite the well-validated McDonald 2017. For proper evaluation of errors in the diagnostic process that lead to misdiagnosis, it is adequate to incorporate patients who are already under regular follow-up at reference centers of demyelinating diseases. Objectives: To evaluate multiple sclerosis misdiagnosis in patients who are on follow-up at a reference center of demyelinating diseases in Brazil. Methods: We designed an observational study including patients in regular follow-up, who were diagnosed with multiple sclerosis at our specialized outpatient clinic in the Hospital of Clinics in the University of Sao Paulo, from 1996 to 2021, and were reassessed for misdiagnosis in 2022. We evaluated demographic information, clinical profile, and complementary exams and classified participants as “established multiple sclerosis,” “non-multiple sclerosis, diagnosed,” and “non-multiple sclerosis, undiagnosed.” Failures in the diagnostic process were assessed by the modified Diagnostic Error Evaluation and Research tool. Results: A total of 201 patients were included. After analysis, 191/201 (95.02%) participants were confirmed as “established multiple sclerosis,” 5/201 (2.49%) were defined as “non-multiple sclerosis, diagnosed,” and 5/201 (2.49%) were defined as “non-multiple sclerosis, undiagnosed.” Conclusions: Multiple sclerosis misdiagnosis persists in reference centers, emphasizing the need for careful interpretation of clinical findings to prevent errors.
KW - Multiple sclerosis
KW - diagnostic error evaluation and research tool
KW - failures in diagnostic process
KW - misdiagnosis
KW - misinterpretation of the magnetic resonance imaging
KW - neuromyelitis optica spectrum disorders
UR - http://www.scopus.com/inward/record.url?scp=85173761211&partnerID=8YFLogxK
U2 - https://doi.org/10.1177/13524585231199323
DO - https://doi.org/10.1177/13524585231199323
M3 - Article
C2 - 37786965
SN - 1352-4585
VL - 29
SP - 1755
EP - 1764
JO - MULTIPLE SCLEROSIS JOURNAL
JF - MULTIPLE SCLEROSIS JOURNAL
IS - 14
ER -