{"id":22006,"date":"2025-06-12T09:44:27","date_gmt":"2025-06-12T13:44:27","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&p=22006"},"modified":"2025-06-25T09:47:08","modified_gmt":"2025-06-25T13:47:08","slug":"phenotyping-healthcare-use-2-3-decades-before-the-first-multiple-sclerosis-demyelinating-event-2","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/phenotyping-healthcare-use-2-3-decades-before-the-first-multiple-sclerosis-demyelinating-event-2\/","title":{"rendered":"Phenotyping healthcare use 2-3 decades before the first multiple sclerosis demyelinating event"},"content":{"rendered":"

Objective<\/strong> \u2014 Phenotype hospital, physician, and emergency department (ED) visits by diagnoses and specialty up to 29\u2009years pre-multiple sclerosis (MS) onset versus a matched population without MS.<\/p>\n

Methods<\/strong> \u2014 We identified people with MS (PwMS) using population-based administrative data from Ontario, Canada (1991\u20132020). 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.<\/p>\n

Results<\/strong> \u2014 Up to 35,018 PwMS and 136,007 population comparators were included. Consistently elevated yearly physician visit rate ratios (RRs) were observed 28\u2009years pre-index for: mental-health (RR >\u20091.29) and ill-defined signs\/symptoms (RR >\u20091.15), 24\u2009years for: nervous (RR >\u20091.47), musculoskeletal (RR >\u20091.21), injury, and respiratory-related issues (RR >\u20091.07), and 22\u2009years for digestive-system (RR >\u20091.18). 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\u201317.13); ill-defined signs\/symptoms (range: 3.51\u20135.45), mental-health (range: 2.13\u20132.70), musculoskeletal (range: 1.84\u20132.96), injury (range: 1.58\u20132.27), digestive-system (range: 1.49\u20131.78) and respiratory-system (range: 1.37\u20132.06). By specialty, yearly visit RRs for primary care were >\u20091.08 for 28\u2009years pre-index, internal medicine exceeded 1.19 for 25\u2009years, and psychiatry and neurology >\u20091.52 for 24\u2009years pre-index.<\/p>\n

Interpretation<\/strong> \u2014 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\u2009years pre-index), followed by nervous-system, musculoskeletal, injury, respiratory-related, and digestive-system (22\u201324\u2009years pre-index). Health-related phenotypical differences appear early in the MS disease process.<\/p>\n","protected":false},"excerpt":{"rendered":"

Objective \u2014 Phenotype hospital, physician, and emergency department (ED) visits by diagnoses and specialty up to 29\u2009years pre-multiple sclerosis (MS) onset versus a matched population without MS. Methods \u2014 We identified people with MS (PwMS) using population-based administrative data from Ontario, Canada (1991\u20132020). The first MS\/demyelinating diagnostic code defined MS onset (the index date). Annual […]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[41,42,62],"migration-helper-qa-sample-set":[],"class_list":["post-22006","journal_article","type-journal_article","status-publish","hentry","topic-brain-diseases","topic-chronic-diseases-and-multimorbidity","topic-health-services-research"],"acf":{"citation":"Tremlett H, Everett K, Maxwell CJ, Zhu F, Asaf A, Li P, McKay KA, Zhao Y, Marrie RA. Ann Clin Transl Neurol<\/em>. 2025; Jun 12 [Epub ahead of print].","source_url":"https:\/\/doi.org\/10.1002\/acn3.70092","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":"\nICES | Phenotyping healthcare use 2-3 decades before the first multiple sclerosis demyelinating event<\/title>\n<meta name=\"description\" content=\"Objective \u2014 Phenotype hospital, physician, and emergency department (ED) visits by diagnoses and specialty up to 29\u2009years pre-multiple sclerosis (MS)\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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