#ClinicSpeak & #BrainHealth: policy document under attack

Does early diagnosis of MS make a difference? #ClinicSpeak #MSBlog

One of our colleagues came back from a recent meeting where one of the speakers repeatedly criticised our 'Brain Health: Time Matters' policy document for not being evidence-based. The policy document is quite broad and covers several aspects in relation to the MS pathway. Many of the statements are supported by evidence, others by scientific principles and some from evidence outside of MS. How much evidence do you need? When is the evidence sufficient to convince the wider community? Should we wait for >90% acceptance, i.e. when the laggards start adopting the policies, or is 50% acceptance rate sufficient? 

One example from the policy document is about activating the community to improve the time to MS diagnosis. Does having a diagnosis of MS earlier affect MS outcomes? I think the data from the CIS and long-term follow-up studies are clear. When the latest economic impact study of MS in Europe was published and showed that the mean time to MS diagnosis after symptom onset was over 8 years I couldn't quite believe it so I asked you all to complete a short survey. Not surprisingly we got very similar results to Gisela Kobelt study (see below). What is interesting is that so many of you had a delayed diagnosis and the reasons for the delay tell it all.

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