Global barriers to MS diagnosis

A new study resulting from a collaboration between MSIF and global experts involved with the Atlas of MS has emphasised the need for better access to education and training for neurologists, in order to help people with MS get a diagnosis as early as possible, wherever they live in the world.

The Atlas of MS global survey, carried out in 2020, was the first time that information about barriers to MS diagnosis worldwide was captured in detail.

The factors affecting diagnosis that were studied included:

• whether the most recent version of MS diagnostic criteria were used;
• barriers to diagnosis with respect to the patient, health care provider, and health system;
• and existence of national guidelines or standards relating to MS diagnosis.

The data showed that there were barriers to timely diagnosis throughout the entire patient journey: lack of patient awareness; lack of health care provider awareness and knowledge/training; and lack of personnel and infrastructure to implement recommendations around diagnosis even if the knowledge and awareness were available.

MSIF believes that an early diagnosis is vital to enable early treatment with disease modifying therapies (DMTs) that can minimise relapses and reduce future disability. You can read more about MSIF’s work to improve access to essential DMTs for MS here. Even if DMTs are not available, an early diagnosis is still crucial as it allows for lifestyle changes to help manage the disease and improve quality of life.

There is evidence that when the most recent diagnostic criteria for MS – the 2017 McDonald criteria  – are used, people with MS can be diagnosed earlier and have better outcomes overall. The Atlas of MS shows that even 2 years after publication of these criteria, many countries are not using them, or if they are, older versions of the diagnostic criteria are used as well. Using these older criteria may unnecessarily delay diagnosis of MS.

The McDonald diagnostic criteria are due to be updated in 2024, and this study highlights the necessity of improving global dissemination and providing education for healthcare providers, to help ensure the criteria are implemented.

Professor Andrew Solomon, who led the study in collaboration with MSIF and researchers from different world regions, says:

“This collaborative effort leveraging novel data from the Atlas of MS concerning global diagnosis of MS highlights challenges with important implications for the neurology community. I am hopeful that bringing attention to these issues will lead to new efforts in professional education and training to help ensure people with MS receive  a diagnosis as early as possible.”

Read the full article here, an editorial about the study here, and a blog from the Kenyan perspective here.

The Atlas of MS data is open source and available to anyone who is interested in conducting their own analyses. Please contact Rachel or Anne at atlas@msif.org if you need any advice about using the Atlas data.

Find out more about how access to MS healthcare varies around the world in our Clinical Management report, and access data about your own country through the Atlas of MS website.