Multiple sclerosis, from referral to confirmed diagnosis: an audit of clinical practice.

Hdl Handle:
http://hdl.handle.net/10147/207470
Title:
Multiple sclerosis, from referral to confirmed diagnosis: an audit of clinical practice.
Authors:
Kelly, S B; Chaila, E; Kinsella, K; Duggan, M; McGuigan, C; Tubridy, N; Hutchinson, M
Affiliation:
Department of Neurology, St Vincent's University Hospital, Dublin, Ireland., sb.kelly@st-vincents.ie
Citation:
Mult Scler. 2011 Aug;17(8):1017-21. Epub 2011 Apr 5.
Journal:
Multiple sclerosis (Houndmills, Basingstoke, England)
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207470
DOI:
10.1177/1352458511403643
PubMed ID:
21467186
Abstract:
BACKGROUND: The National Institute for Health and Clinical Excellence (NICE) guidelines recommend a timeline of 6 weeks from referral to neurology consultation and then 6 weeks to a diagnosis of multiple sclerosis (MS). OBJECTIVES: We audited the clinical management of all new outpatient referrals diagnosed with MS between January 2007 and May 2010. METHODS: We analysed the timelines from referral to first clinic visit, to MRI studies and lumbar puncture (LP) (if performed) and the overall interval from first visit to the time the diagnosis was given to the patient. RESULTS: Of the 119 diagnoses of MS/Clinically Isolated Syndrome (CIS), 93 (78%) were seen within 6 weeks of referral. MRI was performed before first visit in 61% and within 6 weeks in a further 27%. A lumbar puncture (LP) was performed in 83% of all patients and was done within 6 weeks in 78%. In total, 63 (53%) patients received their final diagnosis within 6 weeks of their first clinic visit, with 57 (48%) patients having their diagnosis delayed. The main rate-limiting steps were the availability of imaging and LP, and administrative issues. CONCLUSIONS: We conclude that, even with careful scheduling, it is difficult for a specialist service to obtain MRI scans and LP results so as to fulfil NICE guidelines within the optimal six-week period. An improved service would require MRI scans to be arranged before the first clinic visit in all patients with suspected MS.
Language:
eng
MeSH:
Adolescent; Adult; Female; Humans; Male; *Medical Audit; Middle Aged; Multiple Sclerosis/*diagnosis; *Practice Guidelines as Topic; Referral and Consultation/*standards; Young Adult
ISSN:
1477-0970 (Electronic); 1352-4585 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorKelly, S Ben_GB
dc.contributor.authorChaila, Een_GB
dc.contributor.authorKinsella, Ken_GB
dc.contributor.authorDuggan, Men_GB
dc.contributor.authorMcGuigan, Cen_GB
dc.contributor.authorTubridy, Nen_GB
dc.contributor.authorHutchinson, Men_GB
dc.date.accessioned2012-02-01T10:28:44Z-
dc.date.available2012-02-01T10:28:44Z-
dc.date.issued2012-02-01T10:28:44Z-
dc.identifier.citationMult Scler. 2011 Aug;17(8):1017-21. Epub 2011 Apr 5.en_GB
dc.identifier.issn1477-0970 (Electronic)en_GB
dc.identifier.issn1352-4585 (Linking)en_GB
dc.identifier.pmid21467186en_GB
dc.identifier.doi10.1177/1352458511403643en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207470-
dc.description.abstractBACKGROUND: The National Institute for Health and Clinical Excellence (NICE) guidelines recommend a timeline of 6 weeks from referral to neurology consultation and then 6 weeks to a diagnosis of multiple sclerosis (MS). OBJECTIVES: We audited the clinical management of all new outpatient referrals diagnosed with MS between January 2007 and May 2010. METHODS: We analysed the timelines from referral to first clinic visit, to MRI studies and lumbar puncture (LP) (if performed) and the overall interval from first visit to the time the diagnosis was given to the patient. RESULTS: Of the 119 diagnoses of MS/Clinically Isolated Syndrome (CIS), 93 (78%) were seen within 6 weeks of referral. MRI was performed before first visit in 61% and within 6 weeks in a further 27%. A lumbar puncture (LP) was performed in 83% of all patients and was done within 6 weeks in 78%. In total, 63 (53%) patients received their final diagnosis within 6 weeks of their first clinic visit, with 57 (48%) patients having their diagnosis delayed. The main rate-limiting steps were the availability of imaging and LP, and administrative issues. CONCLUSIONS: We conclude that, even with careful scheduling, it is difficult for a specialist service to obtain MRI scans and LP results so as to fulfil NICE guidelines within the optimal six-week period. An improved service would require MRI scans to be arranged before the first clinic visit in all patients with suspected MS.en_GB
dc.language.isoengen_GB
dc.subject.meshAdolescenten_GB
dc.subject.meshAdulten_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshMaleen_GB
dc.subject.mesh*Medical Auditen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshMultiple Sclerosis/*diagnosisen_GB
dc.subject.mesh*Practice Guidelines as Topicen_GB
dc.subject.meshReferral and Consultation/*standardsen_GB
dc.subject.meshYoung Adulten_GB
dc.titleMultiple sclerosis, from referral to confirmed diagnosis: an audit of clinical practice.en_GB
dc.contributor.departmentDepartment of Neurology, St Vincent's University Hospital, Dublin, Ireland., sb.kelly@st-vincents.ieen_GB
dc.identifier.journalMultiple sclerosis (Houndmills, Basingstoke, England)en_GB
dc.description.provinceLeinster-

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