{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T08:51:44Z","timestamp":1792227104980,"version":"4.4.0"},"reference-count":24,"publisher":"SAGE Publications","issue":"14","license":[{"start":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T00:00:00Z","timestamp":1696291200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To evaluate multiple sclerosis misdiagnosis in patients who are on follow-up at a reference center of demyelinating diseases in Brazil.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>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 \u201cestablished multiple sclerosis,\u201d \u201cnon-multiple sclerosis, diagnosed,\u201d and \u201cnon-multiple sclerosis, undiagnosed.\u201d Failures in the diagnostic process were assessed by the modified Diagnostic Error Evaluation and Research tool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 201 patients were included. After analysis, 191\/201 (95.02%) participants were confirmed as \u201cestablished multiple sclerosis,\u201d 5\/201 (2.49%) were defined as \u201cnon-multiple sclerosis, diagnosed,\u201d and 5\/201 (2.49%) were defined as \u201cnon-multiple sclerosis, undiagnosed.\u201d<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Multiple sclerosis misdiagnosis persists in reference centers, emphasizing the need for careful interpretation of clinical findings to prevent errors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585231199323","type":"journal-article","created":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T04:16:25Z","timestamp":1696306585000},"page":"1755-1764","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Misdiagnosis in multiple sclerosis in a Brazilian reference center: Clinical, radiological, laboratory profile and failures in the diagnostic process\u2014Cohort study"],"prefix":"10.1177","volume":"29","author":[{"given":"Eduardo Macedo de Souza","family":"Tieppo","sequence":"first","affiliation":[{"name":"Neuroimmunology Division, Department of Neurology, Hospital das Cl\u00ednicas da Faculdade de Medicina da USP, Sao Paulo, Brazil"},{"name":"Department of Neurology, Hospital das Cl\u00ednicas, University of Sao Paulo Medical School, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guilherme Diogo","family":"Silva","sequence":"additional","affiliation":[{"name":"Neuroimmunology Division, Department of Neurology, Hospital das Cl\u00ednicas da Faculdade de Medicina da USP, Sao Paulo, Brazil"},{"name":"Department of Neurology, Hospital das Cl\u00ednicas, University of Sao Paulo Medical School, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom\u00e1s Fraga Ferreira da","family":"Silva","sequence":"additional","affiliation":[{"name":"Neuroimmunology Division, Department of Neurology, Hospital das Cl\u00ednicas da Faculdade de Medicina da USP, Sao Paulo, Brazil"},{"name":"Department of Neurology, Hospital das Cl\u00ednicas, University of Sao Paulo Medical School, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger Santana de","family":"Araujo","sequence":"additional","affiliation":[{"name":"Neuroimmunology Division, Department of Neurology, Hospital das Cl\u00ednicas da Faculdade de Medicina da USP, Sao Paulo, Brazil"},{"name":"Department of Neurology, Hospital das Cl\u00ednicas, University of Sao Paulo Medical School, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mateus Boaventura de","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Neuroimmunology Division, Department of Neurology, Hospital das Cl\u00ednicas da Faculdade de Medicina da USP, Sao Paulo, Brazil"},{"name":"Department of Neurology, Hospital das Cl\u00ednicas, University of Sao Paulo Medical School, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana Gondim Peixoto","family":"Spricigo","sequence":"additional","affiliation":[{"name":"Neuroimmunology Division, Department of Neurology, Hospital das Cl\u00ednicas da Faculdade de Medicina da USP, Sao Paulo, Brazil"},{"name":"Department of Neurology, Hospital das Cl\u00ednicas, University of Sao Paulo Medical School, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela Almeida","family":"Pimentel","sequence":"additional","affiliation":[{"name":"Neuroimmunology Division, Department of Neurology, Hospital das Cl\u00ednicas da Faculdade de Medicina da USP, Sao Paulo, Brazil"},{"name":"Department of Neurology, Hospital das Cl\u00ednicas, University of Sao Paulo Medical School, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor Gusm\u00e3o","family":"Campana","sequence":"additional","affiliation":[{"name":"Neuroimmunology Division, Department of Neurology, Hospital das Cl\u00ednicas da Faculdade de Medicina da USP, Sao Paulo, Brazil"},{"name":"Department of Neurology, Hospital das Cl\u00ednicas, University of Sao Paulo Medical School, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno Batitucci","family":"Castrillo","sequence":"additional","affiliation":[{"name":"Neuroimmunology Division, Department of Neurology, Hospital das Cl\u00ednicas da Faculdade de Medicina da USP, Sao Paulo, Brazil"},{"name":"Department of Neurology, Hospital das Cl\u00ednicas, University of Sao Paulo Medical School, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia Trombini","family":"Mendes","sequence":"additional","affiliation":[{"name":"Neuroimmunology Division, Department of Neurology, Hospital das Cl\u00ednicas da Faculdade de Medicina da USP, Sao Paulo, Brazil"},{"name":"Department of Neurology, Hospital das Cl\u00ednicas, University of Sao Paulo Medical School, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larissa Silva","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Neuroimmunology Division, Department of Neurology, Hospital das Cl\u00ednicas da Faculdade de Medicina da USP, Sao Paulo, Brazil"},{"name":"Department of Neurology, Hospital das Cl\u00ednicas, University of Sao Paulo Medical School, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas Mendes","family":"Nunes","sequence":"additional","affiliation":[{"name":"Neuroimmunology Division, Department of Neurology, Hospital das Cl\u00ednicas da Faculdade de Medicina da USP, Sao Paulo, Brazil"},{"name":"Department of Neurology, Hospital das Cl\u00ednicas, University of Sao Paulo Medical School, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3866-1299","authenticated-orcid":false,"given":"Carolina de Medeiros","family":"Rimkus","sequence":"additional","affiliation":[{"name":"Neuroimmunology Division, Department of Neurology, Hospital das Cl\u00ednicas da Faculdade de Medicina da USP, Sao Paulo, Brazil"},{"name":"Department of Neurology, Hospital das Cl\u00ednicas, University of Sao Paulo Medical School, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarso","family":"Adoni","sequence":"additional","affiliation":[{"name":"Neuroimmunology Division, Department of Neurology, Hospital das Cl\u00ednicas da Faculdade de Medicina da USP, Sao Paulo, Brazil"},{"name":"Department of Neurology, Hospital das Cl\u00ednicas, University of Sao Paulo Medical School, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samira Luisa","family":"Ap\u00f3stolos Pereira","sequence":"additional","affiliation":[{"name":"Neuroimmunology Division, Department of Neurology, Hospital das Cl\u00ednicas da Faculdade de Medicina da USP, Sao Paulo, Brazil"},{"name":"Department of Neurology, Hospital das Cl\u00ednicas, University of Sao Paulo Medical School, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dagoberto","family":"Callegaro","sequence":"additional","affiliation":[{"name":"Neuroimmunology Division, Department of Neurology, Hospital das Cl\u00ednicas da Faculdade de Medicina da USP, Sao Paulo, Brazil"},{"name":"Department of Neurology, Hospital das Cl\u00ednicas, University of Sao Paulo Medical School, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,10,3]]},"reference":[{"key":"bibr1-13524585231199323","first-page":"124578","volume":"2014","author":"Wade BJ","year":"2014","journal-title":"Mult Scler 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