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Paul O'Connor, MD, MSc, FRCPC; Allan S. Detsky, MD, PhD, FRCPC; Catherine Tansey, MSc; Walter Kucharczyk, MD, FRCPC; Rochester-Toronto MRI Study Group

Arch Neurol. 1994;51(1):46-51.

Abstract
Background and Methods
We examined the effect on health perceptions of a diagnostic workup in 172 patients with suspected multiple sclerosis (MS) using two questionnnaires (Mishel, Rand Medical Outcome Study) and three visual analogue scales measuring distress. Patients were categorized into "MS," "not MS," or "still uncertain" groups.

Results
Patients with a definitive diagnosis reported a significant decrease in uncertainty (analysis of variance [ANOVA] P=.0004). The Medical Outcome Study showed aslightlyworsened perceived current health status (ANOVA P=.02) and future health outlook (ANOVAP=.001) in the MS group compared with the other two groups. Distress over physical symptoms decreased in all three groups and anxiety was more likely to decrease than increase even in those with MS. Prognostic uncertainty distress decreased in the not MS group and still uncertain groups, whereas it remained unchanged in the MS group (P=.9156).

Conclusion
Significant and generally beneficial changes in patient health perceptions are seen associated with a neurologic workup in suspected MS, irrespective of the final diagnosis.

Author Affiliations
From St Michael's Hospital, Toronto, Ontario (Dr O'Connor); and the University of Toronto (Drs Detsky and Kucharczyk and Ms Tansey).

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