title: Delay in the diagnosis of multiple sclerosis in Croatia.
abstract: BACKGROUND
  The National Institute for Health and Clinical Excellence (NICE) guidelines for multiple sclerosis (MS) recommend the time from initial presentation to first neurological evaluation to be no longer than 6 weeks, and a further 6 weeks until any necessary investigations are completed. The aim of this study was to evaluate how many patients with MS are diagnosed within the NICE timelines in two settings specific for Croatia.
  
  
  METHODS
  All patients with the final diagnosis of clinically isolated syndrome (CIS) or MS in a 6 months period were retrospectively reviewed. We calculated time from first symptom to first neurological evaluation, time from first symptom to MRI scan, time from first neurological evaluation to MRI scan, time from first neurological evaluation to lumbar puncture (LP), time from first symptom to diagnosis and time from first neurological evaluation to diagnosis. We also calculated the percentage of patients fulfilling the NICE timelines.
  
  
  RESULTS
  This study showed that only 61.5% of MS patients in Croatia see neurologist within 6 weeks of first symptoms, and 64.1% are diagnosed within next 6 weeks. However, 80% and 100% of patients presented to the emergency room of our hospital (where a visit to a MS clinic can be automatically made) met the NICE guidelines for time from first symptom to first neurological evaluation and time from first neurological evaluation to diagnosis, respectively.
  
  
  CONCLUSIONS
  A specifically designed demyelinating disease diagnostic clinic offers a better service than other existing models in the diagnosis and management of MS patients.
authors: University Hospital Center Zagreb, Department of Neurology, Referral Center for Demyelinating Diseases of the Central Nervous System, Zagreb, Croatia.
authors: Ivan
authors: I
authors: Adamec
authors: Barbara
authors: B
authors: Barun
authors: Tereza
authors: T
authors: Gabelić
authors: Ivana
authors: I
authors: Zadro
authors: Mario
authors: M
authors: Habek
mesh_terms: D017523:Croatia; D057210:Delayed Diagnosis; D018450:Disease Progression; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009103:Multiple Sclerosis / Q000175:diagnosis*; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies
keywords: Delay; Lumbar puncture; MRI; Multiple sclerosis; Time to diagnosis