Evidence map›Paper›PMID 39665854›Full record

ArticleJournal of neurology2024

Factors affecting the diagnostic delay of myasthenia gravis.

I R Marlet, R K Andersen, K H Axelsen, L K Andersen, J Vissing, N Witting

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Article in Journal of neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

I R MarletCopenhagen Neuromuscular Center, Rigshospitalet, Copenhagen, Denmark. idamarlet@hotmail.com.
R K AndersenCopenhagen Neuromuscular Center, Rigshospitalet, Copenhagen, Denmark.
K H AxelsenCopenhagen Neuromuscular Center, Rigshospitalet, Copenhagen, Denmark.
L K AndersenCopenhagen Neuromuscular Center, Rigshospitalet, Copenhagen, Denmark.
J VissingCopenhagen Neuromuscular Center, Rigshospitalet, Copenhagen, Denmark.
N WittingCopenhagen Neuromuscular Center, Rigshospitalet, Copenhagen, Denmark.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEarly detection and diagnosis of myasthenia gravis (MG) is important to improve the chance of remission and overall prognosis. This study aims to investigate the factors affecting the diagnostic delay of MG thereby highlighting the challenges in the diagnostic process.

methodsWe conducted a retrospective study examining characteristics and factors involved in the diagnostic process of MG. We included 350 patients treated for MG at the Copenhagen Neuromuscular Unit (CNMC), between 1980 and 2022. A total of 315 patients had data on time to diagnosis, which was used to categorize them into an early-and a delayed diagnosis group, based on a median cut-off of 141 days. A separate analysis was conducted for the cases with an extremely delayed time to diagnosis exceeding the upper quartile range of 864 days (n = 28). Finally, change in time to MG diagnosis over time was identified.

resultsThe overall mean time to diagnosis was found to be 331 days (range: 5-4492 days). Patients who experienced a delayed diagnosis were significantly younger at onset (50.4 vs. 55.4 years, p-value < 0.05), and experienced higher frequency of asymptomatic periods (29% vs. 10%, p-value < 0.05). We found a delayed referral to specialists, extended time spent at specialists, and delayed initiation of paraclinical diagnostic tests. Additionally, in the delayed group we found extended time from the initial antibody (AB) evaluation to the first positive result (3.2 vs. 86.1 days, p-value < 0.05). Individuals in the early diagnosis group may be referred to stroke specialist earlier, however, this finding was not statistically significant (18 vs. 464 days, p-value 0.17). Gender, presenting symptom, final type of MG and socioeconomic status where not associated with delayed diagnosis. Generally, a trend of decreasing time to diagnosis over time was observed.

conclusionYounger age at onset, higher prevalence of asymptomatic periods, and a delayed positive AB titer test may be risk factors for a delayed MG diagnosis. Prompt referral to a stroke specialist may lead to an earlier diagnosis.

Indexed as

Delayed DiagnosisMyasthenia GravisAdolescentAdultAgedAged, 80 and overAge of OnsetFemaleHumansMaleMiddle AgedRetrospective StudiesYoung AdultDelayDiagnosisDiagnostic processMyasthenia gravisNeuromuscular junctionTime to diagnosis

Identifiers

PMID39665854

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.