New diagnostic pathway needed for multiple sclerosis: mapping diagnostic delays at referral centre

<h3>Background</h3> In multiple sclerosis (MS), quick diagnosis and treatment can reduce risk of long-term disability. NHS difficulties and current diagnostic pathways cause people with MS (pwMS) to experience significant delays in receiving their diagnosis and treatment. <h3>Methods</h3> Retrospective cohort study of new MS diagnoses (including CIS) in 2023 at a regional centre (n=47). This excludes those referred from other hospitals or private healthcare providers. Analysis of the diagnostic pathway (n=39) excluded those diagnosed acutely. <h3>Results</h3> Time from referral to first neurology appointment was median 1.6 months (IQR 0.7–4.7), with MRI performed median 1.3 months following first appointment (IQR 0.9–3.6). Time from referral to diagnosis was median 3.9 months (IQR 2.0–7.1). This compared with two years from first ever symptoms to first referral. 33% received a lumbar puncture. 10% required ≥2 MRI head following referral (in addition to previous imaging). 11% of pwMS were diagnosed acutely. <h3>Discussion</h3> Although the delay from symptom onset to referral is longer, a significant proportion of pwMS experience many months of diagnostic delay in secondary care. New MS diagnostic biomarkers (central vein sign and paramagnetic rims) could reduce the number of MRIs and lumbar punctures needed to confirm diagnosis. A 2-week diagnostic pathway will be presented.