ArticlePloS one2017
The path to specialist multidisciplinary care in amyotrophic lateral sclerosis: A population- based study of consultations, interventions and costs.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
25 citing papers in PubMed, 61 citations in OpenAlex.
- Astrocyte-derived extracellular vesicle phosphorylated TDP-43 as a blood-based biomarker for amyotrophic lateral sclerosis.Neurobiology of disease · 2026Article
- Very low-amplitude muscle activity increases probability of motor evoked potentials in healthy individuals and in amyotrophic lateral sclerosis.Experimental physiology · 2026Article
- Evidence-based care pathways for people with dementia and neurodegenerative disorders in Europe: a systematic review of models, integration of digital technologies, and quality indicators.Frontiers in medicine · 2026Review
- Respiratory-Onset Amyotrophic Lateral Sclerosis (ALS): A Rare Initial Presentation.Journal of general internal medicine · 2025Article
- Health care resource utilization and costs across stages of amyotrophic lateral sclerosis in the United States.Journal of managed care & specialty pharmacy · 2024Article
- Biomarkers in amyotrophic lateral sclerosis: current status and future prospects.Nature reviews. Neurology · 2023Review
- Exploring Relevant Time Windows in the Association Between PM2.5 Exposure and Amyotrophic Lateral Sclerosis: A Case-Control Study in Denmark.American journal of epidemiology · 2023Article
- Advances in sequencing technologies for amyotrophic lateral sclerosis research.Molecular neurodegeneration · 2023Review
- When months matter; modelling the impact of the COVID-19 pandemic on the diagnostic pathway of Motor Neurone Disease (MND).PloS one · 2023Article
- Effect of neurofilament analysis on the diagnostic delay in amyotrophic lateral sclerosis.CNS neuroscience & therapeutics · 2023Article
- Iranian clinical practice guideline for amyotrophic lateral sclerosis.Frontiers in neurology · 2023Review
- Blood biomarkers in ALS: challenges, applications and novel frontiers.Acta neurologica Scandinavica · 2022Review
- Exploring the association between outcome measures to guide clinical management in patients with amyotrophic lateral sclerosis.Journal of physical therapy science · 2022Article
- Misdiagnoses in a Brazilian population with amyotrophic lateral sclerosis.Arquivos de neuro-psiquiatria · 2022Article
- Design of a Randomized, Placebo-Controlled, Phase 3 Trial of Tofersen Initiated in Clinically Presymptomatic SOD1 Variant Carriers: the ATLAS Study.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2022Article
- Pain in amyotrophic lateral sclerosis: a narrative review.Journal of Yeungnam medical science · 2022Article
- Identifying key signs of motor neurone disease in primary care: a nested case-control study using the QResearch database.BMJ open · 2022Article
- Recent advances in the diagnosis and prognosis of amyotrophic lateral sclerosis.The Lancet. Neurology · 2022Review
- Otolaryngologist's role in the diagnosis of amyotrophic lateral sclerosis.BMJ case reports · 2021Article
- Delayed Diagnosis and Diagnostic Pathway of ALS Patients in Portugal: Where Can We Improve?Frontiers in neurology · 2021Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAmyotrophic Lateral Sclerosis (ALS) is a devastating neurological condition that requires coordinated, multidisciplinary clinical management. ALS is prone to misdiagnosis as its signs and symptoms may be non-specific, which may prolong patients' journey to multidisciplinary ALS care.
methodsUsing chart review and national register data, we have detailed the journey of a national cohort of ALS patients (n = 155) from the time of first symptom to presentation at a multidisciplinary clinic (MDC). Key milestones were analysed, including frequency of consultations, clinical interventions, and associated economic cost.
resultsA majority of patients was male (60%), 65 years of age and over (54%), and had spinal onset ALS (72%). Time from onset of first symptoms to ALS diagnosis was a mean of 15.1 months (median, 11). There was a mean interval of 17.4 months (median 12.5) from first symptoms to arrival at the MDC, and a mean of 4.09 (median, 4) consultations with health care professionals. Electromyography and nerve conduction studies were among the most common interventions. Direct referral by a general practitioner (GP) to a neurologist was associated with reduced cost, but not reduced diagnostic delay. Bulbar ALS was associated with shorter time from symptom onset to diagnosis. Neurologist consultation in the first three consultations was associated with lower costs prior to the ALS clinic attendance but not a shorter time from first symptom to final diagnosis. Mean cost prior to attending the MDC was €3,486 per patient.
conclusionsExpedited referral to the multidisciplinary ALS clinic would have reduced costs by an estimated €2,072 per patient. Development of a standardised pathway with early referral to neurology of patients with suspected symptoms of ALS could limit unnecessary interventions and reduce cost of care.
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