Multiple Sclerosis Diagnosis: A Survey Of Neurology Residents' Knowledge On Current Diagnostic Criteria (P5.194)

Abstract

OBJECTIVE: To evaluate neurology residents’ knowledge of current Multiple Sclerosis (MS) diagnostic criteria. BACKGROUND: The availability of FDA approved treatment for clinically isolated syndrome (CIS) and the McDonald criteria have allowed for early diagnosis and treatment of CIS and MS. Introducing the diagnostic criteria during neurology residency can lead to wider adoption and result in earlier diagnosis and improved outcomes. This survey explores residents’ knowledge of the criteria and identifies gaps in knowledge. DESIGN/METHODS: A survey including questions about CIS, the diagnostic criteria and several CIS and MS cases was emailed to neurology residencies in the US. RESULTS: Residents from many program across all training levels participated. Ten percent of residents were not familiar with CIS and 6% were not familiar with the McDonald criteria (majority in junior training levels, p<0.001 & p=0.004 respectively, chi square test). Only 3% and 33% of residents felt the criteria were easy to use and remember, respectively. In the absence of MRI, only 30% of residents diagnosed CIS while a normal MRI led to a greater proportion of CIS diagnosis (80%, p<0.001, marginal homogeneity test ). Eighty three percent and 92% of residents did not treat CIS with no MRI and a normal MRI, respectively. A second clinical attack led to an MS instead of CIS diagnosis (p<0.001) and 98% offered treatment. When the case met McDonald criteria, 78% of residents diagnosed MS and 15% CIS (p<0.001). Ninety seven percent treated Mcdonald MS and 50% treated CIS that met McDonald criteria. CONCLUSIONS: Neurology residents are familiar with McDonald criteria but find it difficult to use and remember. Some were unable to diagnose MS using the criteria and some were hesitant to treat CIS. Better implementation and knowledge of CIS and MS diagnosis during residency can lead to a more successful use of the criteria and improve patient outcomes. Study Supported by: National MS Society - American Brain foundation clinician scientist development award. Disclosure: Dr. Chahin has nothing to disclose. Dr. Ashok has nothing to disclose. Dr. Price has nothing to disclose. Dr. Markowitz has received personal compensation for activities with Bayer Pharmaceuticals Inc., Biogen Idec, Eli Lilly & Co., EMD Serono, and Teva Neuroscience as a consultant.