Renato Ferrandiz-Espadin, Gabriela Rabasa, Sarah Gasman, Brooke McGinley, Rachael Stovall, S Reza Jafarzadeh, Jean W Liew, Maureen Dubreuil
{"title":"轴性脊柱关节炎放射学诊断时间的差异。","authors":"Renato Ferrandiz-Espadin, Gabriela Rabasa, Sarah Gasman, Brooke McGinley, Rachael Stovall, S Reza Jafarzadeh, Jean W Liew, Maureen Dubreuil","doi":"10.3899/jrheum.2024-0574","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":null,"pages":null},"PeriodicalIF":3.6000,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Disparities in time to diagnosis of Radiographic Axial Spondyloarthritis.\",\"authors\":\"Renato Ferrandiz-Espadin, Gabriela Rabasa, Sarah Gasman, Brooke McGinley, Rachael Stovall, S Reza Jafarzadeh, Jean W Liew, Maureen Dubreuil\",\"doi\":\"10.3899/jrheum.2024-0574\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":50064,\"journal\":{\"name\":\"Journal of Rheumatology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2024-11-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Rheumatology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3899/jrheum.2024-0574\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"RHEUMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Rheumatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3899/jrheum.2024-0574","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
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.
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.