{"id":21897,"date":"2025-05-23T09:39:06","date_gmt":"2025-05-23T13:39:06","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=21897"},"modified":"2025-06-05T09:46:51","modified_gmt":"2025-06-05T13:46:51","slug":"health-care-use-preceding-pediatric-multiple-sclerosis","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/health-care-use-preceding-pediatric-multiple-sclerosis\/","title":{"rendered":"Health care use preceding pediatric multiple sclerosis: a population-based study from Ontario, Canada"},"content":{"rendered":"<p><strong>Background<\/strong> \u2014 Investigations of a prodrome in multiple sclerosis (MS) usually have included adults.<\/p>\n<p><strong>Objective<\/strong> \u2014 To compare rates and reasons for health care use in youth with and without MS, considering time relative to the MS index date and to birth.<\/p>\n<p><strong>Methods<\/strong> \u2014 This retrospective cohort study used population-based administrative data (1991\u20132020) from Ontario, Canada. We matched youth (&lt;18 years) with MS up to 5:1 to youth without MS by sex, birth year, region, and duration of observation (full cohorts). Subcohorts had data from birth to MS index date (first demyelinating disease claim). We compared health services use, adjusting for age, sex, area-level income, region, and year.<\/p>\n<p><strong>Results<\/strong> \u2014 We included 451 individuals with pediatric-onset MS and 1422 without MS. As of 6 years pre-index, the full MS cohort had higher physician services use (year 6: rate ratio (RR) = 1.45; 95% confidence interval (95% CI) = 1.25\u20131.67) and hospitalizations (RR = 2.79; 95% CI = 1.31\u20135.94). Findings were similar in subcohorts. The MS subcohort had elevated physician visit rates in early life that rose as the MS index date approached.<\/p>\n<p><strong>Discussion<\/strong> \u2014 Youth with pediatric-onset MS exhibit increased health care use from birth. Early life may be a risk period for MS. A prodromal phase may emerge 6 years before the onset of typical MS symptoms.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background \u2014 Investigations of a prodrome in multiple sclerosis (MS) usually have included adults. Objective \u2014 To compare rates and reasons for health care use in youth with and without MS, considering time relative to the MS index date and to birth. Methods \u2014 This retrospective cohort study used population-based administrative data (1991\u20132020) from Ontario, [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[16,42,62],"migration-helper-qa-sample-set":[],"class_list":["post-21897","journal_article","type-journal_article","status-publish","hentry","topic-children-and-young-people","topic-chronic-diseases-and-multimorbidity","topic-health-services-research"],"acf":{"citation":"Marrie RA, Maxwell CJ, Everett K, Zhu F, Li P, McKay KA, Zhao Y, Tremlett H.<em> Mult Scler<\/em>. 2025; May 23 [Epub ahead of print].","source_url":"https:\/\/doi.org\/10.1177\/13524585251338745","ices_scientist":[1322],"site":[6733],"research_program":[6746],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Health care use preceding pediatric multiple sclerosis: a population-based study from Ontario, Canada<\/title>\n<meta name=\"description\" content=\"Background \u2014 Investigations of a prodrome in multiple sclerosis (MS) usually have included adults. Objective \u2014 To compare rates and reasons for health\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/health-care-use-preceding-pediatric-multiple-sclerosis\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ICES | Health care use preceding pediatric multiple sclerosis: a population-based study from Ontario, Canada\" \/>\n<meta property=\"og:description\" content=\"Background \u2014 Investigations of a prodrome in multiple sclerosis (MS) usually have included adults. 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