ArticleAnnals of clinical and translational neurology2025
Phenotyping Healthcare Use 2-3 Decades Before the First Multiple Sclerosis Demyelinating Event.
Article in Annals of clinical and translational neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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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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.
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Who cites it
1 citing paper in PubMed.
- The multiple sclerosis prodrome: insights into how and when disease starts.Nature reviews. Neurology · 2025Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
objectivePhenotype hospital, physician, and emergency department (ED) visits by diagnoses and specialty up to 29 years pre-multiple sclerosis (MS) onset versus a matched population without MS.
methodsWe identified people with MS (PwMS) using population-based administrative data from Ontario, Canada (1991-2020). The first MS/demyelinating diagnostic code defined MS onset (the index date). Annual rates of healthcare use (hospital, physician, ED) by primary diagnosis (chapter-level) and physician specialty pre-index were compared between PwMS and up to 5 matched population comparators using overdispersed-Poisson regression.
resultsUp to 35,018 PwMS and 136,007 population comparators were included. Consistently elevated yearly physician visit rate ratios (RRs) were observed 28 years pre-index for: mental-health (RR > 1.29) and ill-defined signs/symptoms (RR > 1.15), 24 years for: nervous (RR > 1.47), musculoskeletal (RR > 1.21), injury, and respiratory-related issues (RR > 1.07), and 22 years for digestive-system (RR > 1.18). The magnitude increased as the index date approached, peaking the year pre-index for physician, hospital, and ED visit RRs for: nervous-system (range: 12.06-17.13); ill-defined signs/symptoms (range: 3.51-5.45), mental-health (range: 2.13-2.70), musculoskeletal (range: 1.84-2.96), injury (range: 1.58-2.27), digestive-system (range: 1.49-1.78) and respiratory-system (range: 1.37-2.06). By specialty, yearly visit RRs for primary care were > 1.08 for 28 years pre-index, internal medicine exceeded 1.19 for 25 years, and psychiatry and neurology > 1.52 for 24 years pre-index.
interpretationHigher healthcare use was evident for over two decades before the first demyelinating event. Mental-related, ill-defined signs/symptoms and primary care visits were consistently elevated the longest (28 years pre-index), followed by nervous-system, musculoskeletal, injury, respiratory-related, and digestive-system (22-24 years pre-index). Health-related phenotypical differences appear early in the MS disease process.
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