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在诊断原发性渐进性多发性硬化症方面面临的现实挑战

Katelijn M Blok^1,2, Joost Smolders^2,3,4, Joost van Rosmalen^5,6

¹Department of Neurology, MS Center of the Albert Schweitzer Hospital, Dordrecht, The Netherlands.

European journal of neurology

|August 14, 2023

概括

诊断原发性渐进性多发性硬化症 (PPMS) 是一个挑战. 2010年和2017年的麦当劳标准在正确应用时具有相似的性能,具有完整的工作,突出需要准确的临床评估.

科学领域:

神经学神经学
临床诊断临床诊断临床诊断
医学研究医学研究

背景情况:

尽管2017年麦当劳标准修订,但诊断原发性渐进性多发性硬化症 (PPMS) 仍然很困难.
在PPMS诊断中的现实世界挑战需要识别以改善临床实践.

研究的目的:

在初级渐进性多发性硬化症 (PPMS) 中识别常见的诊断挑战.
在现实PPMS案例中评估2010年和2017年麦当劳标准的表现.
将诊断挑战与PPMS诊断标准的有效性相关联.

主要方法:

从PPMS患者档案中回顾性分析临床,放射和实验室数据.
鉴定并排除并发症因素:混杂性并发症,替代性诊断,不完整的工作.
在审查复杂因素后,计算诊断标准的满足率.

主要成果:

分析了322名PPMS患者;在一个显著的子集中发现了并发症因素.
当应用于118个完整处理和确认PPMS的病例时,2010年和2017年的麦当劳标准显示了类似的表现 (88.1%与83.1%对比).
在这个选定的队列中,在2010年和2017年的标准之间没有发现显著差异 (p=0.15).

结论:

对初始临床过程的准确解释对于PPMS诊断至关重要.
彻底的诊断工作和考虑替代诊断是必不可少的.
2010年和2017年麦当劳标准在临床实践中适当应用时具有相似的性能.

关键词:

麦当劳的标准麦当劳的标准诊断诊断诊断诊断诊断诊断原发性进展性多发性硬化症.

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