Danielle Richards|John A. Morren|Erik P. Pioro
Time to diagnosis and factors affecting diagnostic delay in amyotrophic lateral sclerosis
The Neurological Institute|Cleveland Clinic|The Neurological Institute|Cleveland Clinic|Cleveland Clinic Lerner College of Medicine|The Neurological Institute|Cleveland Clinic
amyotrophic lateral sclerosis als progressive degenerative neuromuscular disease limited treatment options diagnosis als challenging numerous reasons resulting delays may compromise optimal management enrollment clinical trials several studies examined process challenges regarding clinical diagnosis als twentyone studies almost exclusively english literature published 1990 2020 identified via pubmed using relevant search terms included patient populations united states canada japan egypt several countries south america europe probable definitive als patients identified using el escorial revised el escorialairlie house criteria time diagnosis diagnostic delay defined mean median time patientreported first symptom onset formal diagnosis physician recorded medical records typical time diagnosis 1016 months symptom onset several points delay diagnosis course identified including specialist referrals misdiagnoses often resulting unnecessary procedures surgeries bulbar onset noted significantly reduce time als diagnosis future interventions potential research opportunities reviewed