{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T14:16:41Z","timestamp":1788445001887,"version":"build-2803163510"},"reference-count":46,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"unspecified","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100029249","name":"Horne Family Foundation","doi-asserted-by":"publisher","award":["NA"],"award-info":[{"award-number":["NA"]}],"id":[{"id":"10.13039\/100029249","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,6,19]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The social determinants of health are the conditions in which people live and the systems around them that shape these conditions. Social determinants of health may affect diagnosis and treatment for people with multiple sclerosis (MS) even in countries with universal healthcare systems. This study will investigate whether a person\u2019s age, sex and\/or gender, living in a more socioeconomically deprived area and being of a minoritised ethnicity impact access to a diagnosis of MS and disease-modifying treatments (DMTs) for people living in the catchments of specialist neurology centres with a total estimated catchment population of approximately 7\u2009million people in England and Wales.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>EQUITY-MS is a multicentre retrospective cohort study using routinely collected healthcare data. Study participants are people aged 16 and above who received a new diagnosis of MS between 1 January 2018 and 31 December 2024 while living within the catchment of five specialist neurology centres (located in Leeds, Bradford, Greater Manchester, Cardiff and East London). Data will be collected from patients\u2019 hospital records by clinical teams. The primary outcome is the length of time between MS diagnosis and prescription of any DMT. Secondary outcomes are prescriptions of a high-efficacy DMT and the duration between patient-reported symptom onset and MS diagnosis. We plan to adjust for clinical and demographic factors that could impact prescribing decisions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>\n                      The study was approved by the North West\u2013Greater Manchester East Research Ethics Committee (National Health Service) (25\/NW\/0184) on 14 August 2025. Results will be published in peer-reviewed journals, and summaries will be provided to local MS societies and disseminated via the study website (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/bradfordresearch.nhs.uk\/bradford-centre-for-health-data-science\/equity-ms\/\">https:\/\/bradfordresearch.nhs.uk\/bradford-centre-for-health-data-science\/equity-ms\/<\/jats:ext-link>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-114912","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T13:45:15Z","timestamp":1788443115000},"page":"e114912","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["EQUITY-MS: evaluating the quality of investigation and treatment of multiple sclerosis using data from five specialist neurology centres in the UK\u2014study protocol"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4427-0910","authenticated-orcid":false,"given":"Elizabeth","family":"O\u2019Nions","sequence":"first","affiliation":[{"name":"Bradford Institute for Health Research, Bradford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Lewer","sequence":"additional","affiliation":[{"name":"Bradford Institute for Health Research, Bradford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachael W","family":"Cheung","sequence":"additional","affiliation":[{"name":"Bradford Institute for Health Research, Bradford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9856-0054","authenticated-orcid":false,"given":"Ellen","family":"Da Silva","sequence":"additional","affiliation":[{"name":"Bradford Institute for Health Research, Bradford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joyutpal","family":"Das","sequence":"additional","affiliation":[{"name":"Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Salford, UK"},{"name":"The University of Manchester Faculty of Biology, Medicine and Health, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2993-585X","authenticated-orcid":false,"given":"Ruth","family":"Dobson","sequence":"additional","affiliation":[{"name":"Department of Neurology, The Royal London Hospital, London, UK"},{"name":"Wolfson Institute of Population Health, Queen Mary University of London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rado\u0161","family":"Keravica","sequence":"additional","affiliation":[{"name":"Bradford Institute for Health Research, Bradford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faith","family":"Moyo","sequence":"additional","affiliation":[{"name":"Bradford Institute for Health Research, Bradford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Rog","sequence":"additional","affiliation":[{"name":"Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Salford, UK"},{"name":"University of Salford, Salford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Russell","sequence":"additional","affiliation":[{"name":"Department of Neurology, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cord","family":"Spilker","sequence":"additional","affiliation":[{"name":"Bradford Institute for Health Research, Bradford, UK"},{"name":"Department of Neurology, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3760-6634","authenticated-orcid":false,"given":"Emma","family":"Tallantyre","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital of Wales, Cardiff, UK"},{"name":"Cardiff University School of Medicine, Cardiff, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4156-5046","authenticated-orcid":false,"given":"Helen L","family":"Ford","sequence":"additional","affiliation":[{"name":"Centre for Neurosciences, Leeds General Infirmary, Leeds, UK"},{"name":"University of Leeds Faculty of Medicine and Health, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"2026090306451305000_16.9.e114912.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30443-5"},{"key":"2026090306451305000_16.9.e114912.2","unstructured":"MS Society . 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