medscape:Fatigue predates MS by years
Posted: Wed Jun 08, 2011 3:26 pm
And of course Mark Freedman is quick to water it down
For each patient, the 3 years preceding the index MS claim were analyzed for diagnoses of chronic fatigue syndrome or malaise (ICD-9 diagnostic codes 780.71 or 780.79), as well as fatigue-related prescriptions, other diagnoses, and MS-associated symptoms.
A total of 5305 patients were identified with an index MS claim made between January 1, 2005, and September 30, 2009. Three quarters of the patients were female, and "an overwhelming majority" (67%) were between the ages of 40 and 59 years, said Dr. Berger.
In 1534 (29%) of the identified patients, at least 1 diagnosis of fatigue or malaise preceded their MS diagnosis, and 42% presented with more than 2 such claims.
"To me that's somewhat astonishing because I seldom put fatigue down as a diagnostic code, and I suspect that's true of many of us," said Dr. Berger. "So my belief is that this is probably an under-representation of the number of people that actually have fatigue in advance of the diagnosis of clinically definite MS."
… my belief is that this is probably an under-representation of the number of people that actually have fatigue in advance of the diagnosis of clinically definite MS.
Among those with a diagnosis of fatigue or malaise, a third received the diagnosis 2 to 3 years before their MS diagnosis, and a quarter received it 1 to 2 years before. For the remainder, the fatigue diagnosis came within the year leading up to the diagnosis of MS.
One third of patients with fatigue/malaise had no other neurologic symptoms suggestive of MS, and 38% of the patients with a cluster of symptoms had fatigue present as the first symptom in the cluster. Other symptoms included visual and movement disorders, muscle and speech disorders, facial neuralgia, dizziness, paralysis, and disturbance of skin sensation.
Although fatigue preceded the diagnosis of MS by an average of 501 days, only 10% of patients received such medications as amantadine, pemoline, modafinil, dexamphetamine, methylphenidate, or dextroamphetamine, said Dr. Berger.
Sorry if this is old http://www.medscape.com/viewarticle/744198
For each patient, the 3 years preceding the index MS claim were analyzed for diagnoses of chronic fatigue syndrome or malaise (ICD-9 diagnostic codes 780.71 or 780.79), as well as fatigue-related prescriptions, other diagnoses, and MS-associated symptoms.
A total of 5305 patients were identified with an index MS claim made between January 1, 2005, and September 30, 2009. Three quarters of the patients were female, and "an overwhelming majority" (67%) were between the ages of 40 and 59 years, said Dr. Berger.
In 1534 (29%) of the identified patients, at least 1 diagnosis of fatigue or malaise preceded their MS diagnosis, and 42% presented with more than 2 such claims.
"To me that's somewhat astonishing because I seldom put fatigue down as a diagnostic code, and I suspect that's true of many of us," said Dr. Berger. "So my belief is that this is probably an under-representation of the number of people that actually have fatigue in advance of the diagnosis of clinically definite MS."
… my belief is that this is probably an under-representation of the number of people that actually have fatigue in advance of the diagnosis of clinically definite MS.
Among those with a diagnosis of fatigue or malaise, a third received the diagnosis 2 to 3 years before their MS diagnosis, and a quarter received it 1 to 2 years before. For the remainder, the fatigue diagnosis came within the year leading up to the diagnosis of MS.
One third of patients with fatigue/malaise had no other neurologic symptoms suggestive of MS, and 38% of the patients with a cluster of symptoms had fatigue present as the first symptom in the cluster. Other symptoms included visual and movement disorders, muscle and speech disorders, facial neuralgia, dizziness, paralysis, and disturbance of skin sensation.
Although fatigue preceded the diagnosis of MS by an average of 501 days, only 10% of patients received such medications as amantadine, pemoline, modafinil, dexamphetamine, methylphenidate, or dextroamphetamine, said Dr. Berger.
Sorry if this is old http://www.medscape.com/viewarticle/744198