Multiple Sclerosis Diagnosis and Health Care Utilization

Multiple sclerosis (MS) is a chronic inflammatory disorder of the central nervous system characterised by demyelination and axonal injury. Early and accurate diagnosis is critical to initiate disease-modifying therapies and to optimise long-term outcomes. However, diagnostic pathways vary widely, leading to delays that can span months or years. Concurrently, people with MS often exhibit increased rates of health care utilisation both before and after diagnosis, reflecting prodromal symptoms, comorbidities and the need for multidisciplinary care. Patterns of hospitalisations, outpatient visits, prescription fills and use of specialty services inform our understanding of disease evolution and the burden on health systems. Recent advances in prodromal research, digital health platforms and population-based studies have deepened insights into pre-diagnostic health service contact, uncovering opportunities for earlier recognition and more efficient care delivery. Global variations in diagnostic intervals, access to neurology care and adoption of telemedicine underscore the need for standardised pathways and equitable resource allocation.

Research from Nature Portfolio

A study conducted in Upper Egypt examined factors contributing to delayed MS diagnosis, finding that non-motor presentations, initial consultation outside neurology and misdiagnoses were major predictors of longer intervals from symptom onset to diagnosis. Delays in obtaining magnetic resonance imaging further compounded diagnostic lag. Multivariable analysis identified prior misdiagnosis and first presentation to non-neurological specialists as independent risk factors. These findings highlight the importance of raising awareness of variable clinical presentations and streamlining referral processes to reduce diagnostic delay and enable earlier treatment initiation.

Multiple Sclerosis Diagnosis and Health Care Utilization publication trend

The graph below shows the total number of articles in multiple sclerosis diagnosis and health care utilization across all publications each year (not limited to Nature Index journals).

Technical terms

Prodromal phase: Early period with non-specific symptoms preceding overt MS diagnosis.

Diagnostic delay: Interval between first symptom onset and formal diagnosis of MS.

Health care utilisation: Frequency of use of services such as hospitalisations, outpatient visits and prescription fills.

Expanded Disability Status Scale (EDSS): A numerical scale (0–10) quantifying neurological impairment and disability in MS.

Electronic health record: A standardised digital system for collecting, storing and sharing patient health information.

References

1. Building digital patient pathways for the management and treatment of multiple sclerosis. Frontiers in Immunology (2024).
2. Prodromal multiple sclerosis: considerations and future utility. Journal of Neurology (2024).
3. Higher healthcare use before paediatric multiple sclerosis onset: a nationwide cohort study. Brain Communications (2025).
4. Multiple sclerosis diagnostic delay and its associated factors in Upper Egyptian patients. Scientific Reports (2023).