Priority 1 from the Degenerative Cervical Myelopathy PSP

UNCERTAINTY: What strategies can be used to increase awareness and understanding of DCM amongst healthcare professionals and the general public? Can these strategies help improve timely diagnosis and management of DCM? (JLA PSP Priority 1)
Overall ranking	1
JLA question ID	0097/1
Explanatory note	A study by Behrbalk et al (2013) evaluated the time to diagnosis in patients with typical signs and symptoms of DCM and analyzed what factors contributed to a delay. In this study, the mean time to diagnosis was 2.2 years. The most common diagnoses given to these patients were carpel tunnel syndrome and cervical disc radiculopathy without neurological deficit. The typical workup included upper limb EMG, cervical spine CT and bone scan. Furthermore, very few patients were immediately referred to neurosurgery or orthopedic surgery. No other studies were identified that explored the awareness and understanding of DCM amongst healthcare professionals and the general public. It is critical to improve education at the medical school level and during post-graduate training in order to ensure timely diagnosis of this condition.
Evidence	No systematic reviews, scoping reviews or guidelines identified.
Health Research Classification System category	Neurological

Extra information provided by this PSP
Original uncertainty examples	Why are so many GPs and physiotherapist unaware of myelopathy? ~ Can precise examination of GP after education course help with early diagnose DCM? ~ How do we educate primary care physicians/allied health to detect DCM early? ~ What will the medical schools do to educate current medical doctors and future medical doctors as well therapists about DCM / diagnosis? ~ Do variations in GP awareness of DCM affect outcomes?" ~ What is being done to raise awareness of the seriousness of the condition?
Submitted by	Spinal Surgeons x 21, Other healthcare professionals x 14, People with DCM and their supporters x 52

Extra information provided by this PSP

Original uncertainty examples

Why are so many GPs and physiotherapist unaware of myelopathy? ~ Can precise examination of GP after education course help with early diagnose DCM? ~ How do we educate primary care physicians/allied health to detect DCM early? ~ What will the medical schools do to educate current medical doctors and future medical doctors as well therapists about DCM / diagnosis? ~ Do variations in GP awareness of DCM affect outcomes?" ~ What is being done to raise awareness of the seriousness of the condition?

Submitted by

Spinal Surgeons x 21, Other healthcare professionals x 14, People with DCM and their supporters x 52

PSP information
PSP unique ID	0097
PSP name	Degenerative Cervical Myelopathy
Total number of uncertainties identified by this PSP.	76 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop	20 November 2019