Phenotyping Healthcare Use 2–3 Decades Before the First Multiple Sclerosis Demyelinating Event
ABSTRACT Objective Phenotype hospital, physician, and emergency department (ED) visits by diagnoses and specialty up to 29 years pre‐multiple sclerosis (MS) onset versus a matched population without MS. Methods We identified people with MS (PwMS) using population‐based administrative data from Ontar...
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Wiley
2025-08-01
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| Series: | Annals of Clinical and Translational Neurology |
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| Online Access: | https://doi.org/10.1002/acn3.70092 |
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| author | Helen Tremlett Karl Everett Colleen J. Maxwell Feng Zhu Ayesha Asaf Ping Li Kyla A. McKay Yinshan Zhao Ruth Ann Marrie |
| author_facet | Helen Tremlett Karl Everett Colleen J. Maxwell Feng Zhu Ayesha Asaf Ping Li Kyla A. McKay Yinshan Zhao Ruth Ann Marrie |
| author_sort | Helen Tremlett |
| collection | DOAJ |
| description | ABSTRACT Objective Phenotype hospital, physician, and emergency department (ED) visits by diagnoses and specialty up to 29 years pre‐multiple sclerosis (MS) onset versus a matched population without MS. Methods We identified people with MS (PwMS) using population‐based administrative data from Ontario, Canada (1991–2020). The first MS/demyelinating diagnostic code defined MS onset (the index date). Annual rates of healthcare use (hospital, physician, ED) by primary diagnosis (chapter‐level) and physician specialty pre‐index were compared between PwMS and up to 5 matched population comparators using overdispersed‐Poisson regression. Results Up to 35,018 PwMS and 136,007 population comparators were included. Consistently elevated yearly physician visit rate ratios (RRs) were observed 28 years pre‐index for: mental‐health (RR > 1.29) and ill‐defined signs/symptoms (RR > 1.15), 24 years for: nervous (RR > 1.47), musculoskeletal (RR > 1.21), injury, and respiratory‐related issues (RR > 1.07), and 22 years for digestive‐system (RR > 1.18). The magnitude increased as the index date approached, peaking the year pre‐index for physician, hospital, and ED visit RRs for: nervous‐system (range: 12.06–17.13); ill‐defined signs/symptoms (range: 3.51–5.45), mental‐health (range: 2.13–2.70), musculoskeletal (range: 1.84–2.96), injury (range: 1.58–2.27), digestive‐system (range: 1.49–1.78) and respiratory‐system (range: 1.37–2.06). By specialty, yearly visit RRs for primary care were > 1.08 for 28 years pre‐index, internal medicine exceeded 1.19 for 25 years, and psychiatry and neurology > 1.52 for 24 years pre‐index. Interpretation Higher healthcare use was evident for over two decades before the first demyelinating event. Mental‐related, ill‐defined signs/symptoms and primary care visits were consistently elevated the longest (28 years pre‐index), followed by nervous‐system, musculoskeletal, injury, respiratory‐related, and digestive‐system (22–24 years pre‐index). Health‐related phenotypical differences appear early in the MS disease process. |
| format | Article |
| id | doaj-art-e018a795c59f43538e49a5f98f8c49ca |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-08-01 |
| publisher | Wiley |
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| series | Annals of Clinical and Translational Neurology |
| spelling | doaj-art-e018a795c59f43538e49a5f98f8c49ca2025-08-20T03:41:57ZengWileyAnnals of Clinical and Translational Neurology2328-95032025-08-011281585159410.1002/acn3.70092Phenotyping Healthcare Use 2–3 Decades Before the First Multiple Sclerosis Demyelinating EventHelen Tremlett0Karl Everett1Colleen J. Maxwell2Feng Zhu3Ayesha Asaf4Ping Li5Kyla A. McKay6Yinshan Zhao7Ruth Ann Marrie8Faculty of Medicine (Neurology), and the Djavad Mowafaghian Centre for Brain Health University of British Columbia Vancouver British Columbia CanadaIces Toronto Ontario CanadaIces Toronto Ontario CanadaFaculty of Medicine (Neurology), and the Djavad Mowafaghian Centre for Brain Health University of British Columbia Vancouver British Columbia CanadaIces Toronto Ontario CanadaIces Toronto Ontario CanadaDepartment of Clinical Neuroscience Karolinska Institutet Stockholm SwedenFaculty of Medicine (Neurology), and the Djavad Mowafaghian Centre for Brain Health University of British Columbia Vancouver British Columbia CanadaDepartment of Medicine, Rady Faculty of Health Sciences, Max Rady College of Medicine University of Manitoba Winnipeg Manitoba CanadaABSTRACT Objective Phenotype hospital, physician, and emergency department (ED) visits by diagnoses and specialty up to 29 years pre‐multiple sclerosis (MS) onset versus a matched population without MS. Methods We identified people with MS (PwMS) using population‐based administrative data from Ontario, Canada (1991–2020). The first MS/demyelinating diagnostic code defined MS onset (the index date). Annual rates of healthcare use (hospital, physician, ED) by primary diagnosis (chapter‐level) and physician specialty pre‐index were compared between PwMS and up to 5 matched population comparators using overdispersed‐Poisson regression. Results Up to 35,018 PwMS and 136,007 population comparators were included. Consistently elevated yearly physician visit rate ratios (RRs) were observed 28 years pre‐index for: mental‐health (RR > 1.29) and ill‐defined signs/symptoms (RR > 1.15), 24 years for: nervous (RR > 1.47), musculoskeletal (RR > 1.21), injury, and respiratory‐related issues (RR > 1.07), and 22 years for digestive‐system (RR > 1.18). The magnitude increased as the index date approached, peaking the year pre‐index for physician, hospital, and ED visit RRs for: nervous‐system (range: 12.06–17.13); ill‐defined signs/symptoms (range: 3.51–5.45), mental‐health (range: 2.13–2.70), musculoskeletal (range: 1.84–2.96), injury (range: 1.58–2.27), digestive‐system (range: 1.49–1.78) and respiratory‐system (range: 1.37–2.06). By specialty, yearly visit RRs for primary care were > 1.08 for 28 years pre‐index, internal medicine exceeded 1.19 for 25 years, and psychiatry and neurology > 1.52 for 24 years pre‐index. Interpretation Higher healthcare use was evident for over two decades before the first demyelinating event. Mental‐related, ill‐defined signs/symptoms and primary care visits were consistently elevated the longest (28 years pre‐index), followed by nervous‐system, musculoskeletal, injury, respiratory‐related, and digestive‐system (22–24 years pre‐index). Health‐related phenotypical differences appear early in the MS disease process.https://doi.org/10.1002/acn3.70092administrative datahealthcare usemultiple sclerosispopulation‐basedprodrome |
| spellingShingle | Helen Tremlett Karl Everett Colleen J. Maxwell Feng Zhu Ayesha Asaf Ping Li Kyla A. McKay Yinshan Zhao Ruth Ann Marrie Phenotyping Healthcare Use 2–3 Decades Before the First Multiple Sclerosis Demyelinating Event Annals of Clinical and Translational Neurology administrative data healthcare use multiple sclerosis population‐based prodrome |
| title | Phenotyping Healthcare Use 2–3 Decades Before the First Multiple Sclerosis Demyelinating Event |
| title_full | Phenotyping Healthcare Use 2–3 Decades Before the First Multiple Sclerosis Demyelinating Event |
| title_fullStr | Phenotyping Healthcare Use 2–3 Decades Before the First Multiple Sclerosis Demyelinating Event |
| title_full_unstemmed | Phenotyping Healthcare Use 2–3 Decades Before the First Multiple Sclerosis Demyelinating Event |
| title_short | Phenotyping Healthcare Use 2–3 Decades Before the First Multiple Sclerosis Demyelinating Event |
| title_sort | phenotyping healthcare use 2 3 decades before the first multiple sclerosis demyelinating event |
| topic | administrative data healthcare use multiple sclerosis population‐based prodrome |
| url | https://doi.org/10.1002/acn3.70092 |
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