Neurologia 2002 Apr;17(4):179-82
Sastre-Garriga J, Rio J, Nos C, Galan I, Tintore M, Montalban X.
Unidad de Neuroinmunologia Clinica. Hospital Vall d'Hebron. Barcelona. Spain.
The need for optimal care has led to implementation of multiple sclerosis care units, specialised in diagnosis and follow-up of multiple sclerosis patients. Since information on multiple sclerosis prognosis is crucial, accurate diagnosis is one of their major roles.
Prospective analysis of first visits during a year (origin and diagnosis) at the Unidad de Neuroinmunologia Clinica of Hospital Vall d'Hebron.
A total of 437 first visits were analysed; a moderate agreement (kappa = 0.468) between referral diagnoses and diagnosis at follow-up was obtained; agreement was very good (kappa = 0.844) between diagnosis at first visit and diagnosis at follow-up. In the subgroup of 200 patients with a demyelinating disease on follow-up after one year, 37.6% of referrals came from other non-specialised centers and 40.6% from our own center.
Specialised care units enhance diagnostic precision; direct influence zone and non-specialised centers referrals are their more important sources of patients.