{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:56:24Z","timestamp":1792796184582,"version":"4.5.0"},"reference-count":27,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"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":["Multiple Sclerosis Journal \u2013 Experimental, Translational and Clinical"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Research cohort data suggest diagnostic delay in multiple sclerosis (MS) has diminished in tandem with MS diagnostic criteria revisions, yet other studies have not replicated this finding. Recent data indicate misdiagnosis of initial symptoms of MS is a frequent contributor to diagnostic delay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This survey study assessed diagnostic delay and misdiagnosis in an MS patient registry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Participants completed the survey study between November 12, 2021, through December 22, 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were 428 participants. Diagnostic delay was a median of 2.0 months (mean of 22.8 months, range: 0\u201332.9 years); 173\/428 (40.4%) reported misdiagnosis of symptoms later attributed to MS, and this was associated with longer diagnostic delay (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Diagnostic delay decreased over time proximal to revisions to MS diagnostic criteria. 217\/428 (50.7%) reported earlier symptoms retrospectively recognized as referable to MS that were not clinically evaluated, resulting in a diagnostic delay median of 5.4 years (mean 8.9 years, range: 0\u201347.4 years).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Diagnostic delay was prevalent and associated with frequent misdiagnosis of initial symptoms of MS and earlier unevaluated symptoms later attributed to MS. Studies tracing the diagnostic journey of patients with MS are needed to understand and prevent causes of diagnostic delay.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20552173251333390","type":"journal-article","created":{"date-parts":[[2025,4,19]],"date-time":"2025-04-19T06:20:22Z","timestamp":1745043622000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Diagnostic delay and misdiagnosis of symptoms reported by patients with multiple sclerosis participating in a research registry"],"prefix":"10.1177","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1602-1554","authenticated-orcid":false,"given":"Andrew J","family":"Solomon","sequence":"first","affiliation":[{"name":"Larner College of Medicine at the University of Vermont, Department of Neurological Sciences, Burlington, VT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah M","family":"Weinstein","sequence":"additional","affiliation":[{"name":"Temple University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8627-8203","authenticated-orcid":false,"given":"Russell T","family":"Shinohara","sequence":"additional","affiliation":[{"name":"Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samar M","family":"Aoun","sequence":"additional","affiliation":[{"name":"University of Western Australia, Perron Institute for Neurological and Translational Science, La Trobe University, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hollie","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Accelerated Cure Project, Waltham, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9930-7579","authenticated-orcid":false,"given":"Alessandra","family":"Solari","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Istituto Neurologico Carlo Besta"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,4,17]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000207664"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2022-329169"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000012087"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000012726"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000713"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000207481"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ncl.2023.07.001"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/13524585231197076"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2024.105628"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2022.104373"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-021-06737-1"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000178891.20579.64"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(23)00148-5"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(24)00256-4"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/1352458520910496"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/13524585211048401"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurol.2023.04.006"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000012074"},{"key":"e_1_3_3_20_2","first-page":"489","article-title":"Patterns of misdiagnosis of multiple sclerosis","volume":"5","author":"Levin N","year":"2003","unstructured":"Levin N, Mor M, Ben-Hur T. 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