Changing the Multiple Sclerosis Diagnostic Pathway: Insights From Stakeholders on Implementing Novel Radiological Biomarkers.

BACKGROUND: The multiple sclerosis (MS) diagnostic process can be lengthy and result in psychological distress and treatment delays. The 2024 revised McDonald diagnostic criteria incorporate the central vein sign (CVS) and paramagnetic rim lesions (PRL), radiological biomarkers that offer the potent...

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Publicado en:International Journal of MS Care Vol. 28; no. 1; pp. 32 - 40
Autores principales: Gilmartin, Christopher, Paskin, Thomas, Shuen, Chloe Chieng Shiao, de Dios Pérez, Blanca, Clarke, Margareta, Taylor, Lauren, Evangelou, Nikos
Formato: research tables/charts Journal Article
Publicado: Consortium of Multiple Sclerosis Centers Jan/Feb2026
Acceso en línea:Ver este registro en EBSCOhost
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      jtl: International Journal of MS Care
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    pubinfo:
      dt: Jan/Feb2026
      vid: 28
      iid: 1
      pid: 66082
      pub: Consortium of Multiple Sclerosis Centers
      place: Hackensack, New Jersey
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        192492769
        192492769
        192492769
        10.7224/1537-2073.2025-022
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        atl: Changing the Multiple Sclerosis Diagnostic Pathway: Insights From Stakeholders on Implementing Novel Radiological Biomarkers.
      aug:
        au:
          Gilmartin, Christopher
          Paskin, Thomas
          Shuen, Chloe Chieng Shiao
          de Dios Pérez, Blanca
          Clarke, Margareta
          Taylor, Lauren
          Evangelou, Nikos
        affil: School of Medicine, University of Nottingham, Nottingham, United Kingdom
      sug:
        subj:
          Multiple Sclerosis Diagnosis
          Diagnostic Imaging
          Biological Markers Diagnostic Use
          Attitude of Health Personnel Evaluation
          Patient Attitudes Evaluation
          Implementation Science Evaluation
          Uncertainty
          Demyelinating Diseases Diagnosis
          Magnetic Resonance Imaging
          Human
          Male
          Female
          Semi-Structured Interview
          Descriptive Statistics
          Focus Groups
          Health Care Delivery
          Healthcare Disparities
          Communication
          Multidisciplinary Care Team
          Support, Psychosocial
          Patient Satisfaction
          Cost Effectiveness Analysis
          Sensitivity and Specificity
          Data Analysis Software
          Pilot Studies
          Qualitative Studies
          Spinal Puncture Utilization
          Decision Making, Clinical
          United Kingdom
          Funding Source
          Male
          Female
      ab: BACKGROUND: The multiple sclerosis (MS) diagnostic process can be lengthy and result in psychological distress and treatment delays. The 2024 revised McDonald diagnostic criteria incorporate the central vein sign (CVS) and paramagnetic rim lesions (PRL), radiological biomarkers that offer the potential to improve the diagnostic pathway. METHODS: The study aims were to: (1) investigate the experiences of people with MS and health care professionals (HCPs) regarding the current diagnostic process, and (2) identify the barriers and facilitators to implementing the revised diagnostic criteria. Semistructured individual interviews and focus groups were conducted with 10 HCPs and 9 people with MS. Framework analysis, applying normalization process theory, was employed. RESULTS: Interviews revealed 4 themes: current challenges for the diagnostic pathway, CVS/PRL implementation barriers, the benefits of CVS/PRL implementation, and suggestions for overcoming implementation barriers and improving the diagnostic pathway . Challenges to implementation include pathway inefficiencies, care delivery inequality, insufficient communication, financial constraints, capacity limitations, and clinician hesitancy with the revised criteria. Suggested strategies for implementation and improvement included HCP training, enhancing interdisciplinary collaboration, evaluating implemented changes, and delivering emotional and practical support during diagnosis. Benefits for CVS/PRL implementation included reduced reliance on lumbar punctures, improved patient experience, cost-effectiveness, and enhanced diagnostic accuracy. CONCLUSIONS: Despite patient enthusiasm, implementing the revised diagnostic criteria will be challenging and possibly delayed unless HCP concerns are appropriately addressed.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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