化脓性扁桃体炎的公平与结果事件:探索现实世界中与诊断延迟相关的效应调节因素

IF 3.5 3区 医学 Q1 DERMATOLOGY
Dermatology and Therapy Pub Date : 2024-12-01 Epub Date: 2024-11-02 DOI:10.1007/s13555-024-01291-0
Nicole Murray, Isabel Truman, Gary Milligan, Himanshu Modi, Nicholas Adlard
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引用次数: 0

摘要

导言:化脓性扁桃体炎(HS)患者的诊断严重滞后,从症状出现到确诊平均需要 7-10 年时间,但造成这种情况的原因在很大程度上仍不为人所知。本研究从医疗保健系统公平性的角度调查了诊断延迟的驱动因素:方法:我们进行了文献综述,以确定已发表的与房颤诊断延迟相关的因素,为数据分析提供依据。阿德尔菲HS疾病专项计划(DSP)™是2020/2021年对法国、德国、意大利、西班牙、英国和美国的皮肤科医生及其就诊患者进行的一项真实世界横断面调查,该计划提供的临床和人口统计学数据被用于模拟从症状出现到首次就诊的诊断延迟影响因素:在现有证据最多的文献中,影响 HS 诊断延误的因素包括误诊、专家转诊延误和患者尴尬。数据分析显示,年龄的增加与症状出现后诊断延迟的减少有关。白种人或德国人的 HS 患者也更有可能更快得到诊断。吸烟者、合并症患者或有HS家族史的患者确诊速度较慢。在评估首次就诊后的诊断时间时,年龄越大,诊断越快。此外,有 HS 家族史的患者确诊较快,而体重指数高、并发症多、在职、由多名医生管理或欧洲人的患者确诊较晚:在对真实世界数据进行全面分析的基础上,确定了可能影响 HS 及时诊断的多种因素。本研究首次量化了这些影响因素的相对影响,为更快诊断和改善疾病预后需要关注的领域提供了有价值的见解。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Equity and Outcome Events in Hidradenitis Suppurativa: Exploring Effect Modifiers Associated with Diagnostic Delay in the Real World.

Introduction: Patients with hidradenitis suppurativa (HS) experience significantly delayed diagnoses of 7-10 years from symptom onset on average, but the reasons for this remain largely unknown. This study investigated drivers of diagnostic delay from the perspective of healthcare system equity.

Methods: A literature review was performed to identify published factors associated with delayed HS diagnosis to inform data analysis. Clinical and demographic data from the Adelphi HS Disease Specific Programme (DSP)™, a real-world cross-sectional survey of dermatologists and their consulting patients in France, Germany, Italy, Spain, the UK and the USA in 2020/2021, were used to model factors influencing delay to diagnosis from onset of symptoms and first consultation.

Results: Factors influencing delay to HS diagnosis in the literature with the most available evidence were misdiagnosis, delay in specialist referral and patient embarrassment. Data analysis revealed that increasing age was associated with reduced diagnostic delay after symptom onset. Patients with HS who were White or in Germany were also more likely to receive a faster diagnosis. Smokers, patients with concomitant conditions, or a family history of HS were slower to be diagnosed. When time to diagnosis following first consultation was assessed, increasing age was associated with quicker diagnosis. Moreover, patients with a family history of HS were diagnosed quicker, whereas those with high body mass index, more concomitant conditions, in employment, managed by multiple physicians or European were more delayed.

Conclusion: On the basis of a thorough analysis of real-world data, multiple factors that potentially influenced the timely diagnosis of HS have been identified. For the first time, this study quantifies the relative impact of these modifiers, providing valuable insights into areas that require attention for faster diagnoses and improved disease outcomes.

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来源期刊
Dermatology and Therapy
Dermatology and Therapy Medicine-Dermatology
CiteScore
6.00
自引率
8.80%
发文量
187
审稿时长
6 weeks
期刊介绍: Dermatology and Therapy is an international, open access, peer-reviewed, rapid publication journal (peer review in 2 weeks, published 3–4 weeks from acceptance). The journal is dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of dermatological therapies. Studies relating to diagnosis, pharmacoeconomics, public health and epidemiology, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to all clinical aspects of dermatology, such as skin pharmacology; skin development and aging; prevention, diagnosis, and management of skin disorders and melanomas; research into dermal structures and pathology; and all areas of aesthetic dermatology, including skin maintenance, dermatological surgery, and lasers. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/case series, trial protocols, and short communications. Dermatology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an International and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals. The journal appeals to a global audience and receives submissions from all over the world.
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