Rheum for earlier recognition: patient reported time to diagnosis of juvenile idiopathic arthritis.

Abstract

Objectives: Early diagnosis of juvenile idiopathic arthritis (JIA) improves long-term outcomes. The study aims to assess patient reported time to diagnosis with JIA and signs of disease-related damage at the time of diagnosis.

Methods: Retrospective cohort study of patients with an incident JIA diagnosis at an academic center over a 2-year period. Patient reported time to diagnosis and signs of disease-related damage were extracted from the electronic medical record. Factors associated with time to diagnosis were evaluated with regression modeling.

Results: Of the 237 children diagnosed during the study period, the median patient reported time to diagnosis was 19 weeks (IQR: 8-40, range: 1-311). Time to diagnosis was >1 year in 23.5 % of patients, and >2 years in 11.7 %. In the linear regression model, older age was associated with longer time to diagnosis. Many patients (40.9 %) had at least one sign of damage. Damage was most common in younger children and children with oligoarticular disease.

Conclusions: It is common for patients with JIA to have a prolonged time to diagnosis, and many have damage at diagnosis. A regression model fails to explain most of the variance in the time to diagnosis, suggesting there is much to learn about the drivers of diagnostic delay in JIA.