轴性脊柱关节炎放射学诊断时间的差异。

IF 3.6 2区 医学 Q2 RHEUMATOLOGY Journal of Rheumatology Pub Date : 2024-11-04 DOI:10.3899/jrheum.2024-0574
Renato Ferrandiz-Espadin, Gabriela Rabasa, Sarah Gasman, Brooke McGinley, Rachael Stovall, S Reza Jafarzadeh, Jean W Liew, Maureen Dubreuil
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引用次数: 0

摘要

目的:放射性轴性脊柱关节炎(r-axSpA)的平均诊断延迟时间为 7 年。虽然已经评估了性或性别对诊断时间的影响,但对健康的社会决定因素的作用仍然研究不足。我们评估了从最初临床记录 r-axSpA 症状到 r-axSpA 诊断(诊断延迟)的时间是否会因性别、种族、民族或是否存在社会需求而有所不同:我们对一家三级医疗中心 2000 年至 2022 年的 r-axSpA 患者进行了研究。该队列由观察性健康数据科学与信息学(OHDSI)网络建立。在主要分析中,我们评估了从背痛/脊柱痛到确诊r-axSpA的时间,其次评估了从任何其他r-axSpA相关疾病到确诊r-axSpA的时间。为了估计诊断延迟的差异,我们采用了一个参数生存模型,即加速失败时间:我们共纳入了 404 名患者(平均年龄 49 岁,37% 为女性),其中 25.5% 为黑人,31.1% 为其他或未知种族,14.1% 为西班牙裔。有社会需求记录的患者从背痛到确诊 r-axSpA 的时间增加了 21%(95% CI 0.93,1.56)。在患有任何与 r-axSpA 相关疾病的患者中,确诊时间同样增加了 21% (95% CI 0.92, 1.57)。考虑到平均诊断时间为 34 个月,社会需求使诊断时间延长了 7 个月:本研究显示,r-axSpA 的诊断延迟趋势与社会需求、性别、种族和民族有关。未来的研究应重点关注转诊策略,以实现及时诊断和优化护理。
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Disparities in time to diagnosis of Radiographic Axial Spondyloarthritis.

Objective: Radiographic axial spondyloarthritis (r-axSpA) has a 7-year average diagnostic delay. While the impact of sex or gender on time to diagnosis has been evaluated, the role of social determinants of health remains understudied. We assessed whether time from initial clinical documentation of r-axSpA symptoms to r-axSpA diagnosis (diagnostic delay) varies based on sex, race, ethnicity, or the presence of social needs.

Methods: We studied patients with r-axSpA from a tertiary center from 2000 to 2022. The cohort was built with the Observational Health Data Sciences and Informatics (OHDSI) network. For the primary analysis, we assessed the time from back pain/spinal pain to r-axSpA diagnosis and secondarily, the time to r-axSpA from any other r-axSpA -related condition. To estimate differences in diagnostic delay, we employed a parametric survival model, accelerated failure time.

Results: We included 404 patients (mean age 49, 37% female), with 25.5% identifying as Black, 31.1% as other or unknown race and 14.1% as Hispanic. Patients with a documented social need had a 21% increase in time from back pain to r-axSpA diagnosis (95% CI 0.93, 1.56). In patients with any r-axSpA related condition, time to diagnosis increased similarly by 21% (95% CI 0.92, 1.57). Considering an average time to diagnosis of 34 months, a social need increased time to diagnosis by 7 months.

Conclusion: This study reveals a trend toward diagnostic delay in r-axSpA related to social need, sex, race, and ethnicity. Future studies should focus on referral strategies to enable prompt diagnosis and optimize care.

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来源期刊
Journal of Rheumatology
Journal of Rheumatology 医学-风湿病学
CiteScore
6.50
自引率
5.10%
发文量
285
审稿时长
1 months
期刊介绍: The Journal of Rheumatology is a monthly international serial edited by Earl D. Silverman. The Journal features research articles on clinical subjects from scientists working in rheumatology and related fields, as well as proceedings of meetings as supplements to regular issues. Highlights of our 41 years serving Rheumatology include: groundbreaking and provocative editorials such as "Inverting the Pyramid," renowned Pediatric Rheumatology, proceedings of OMERACT and the Canadian Rheumatology Association, Cochrane Musculoskeletal Reviews, and supplements on emerging therapies.
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