Diagnostic delay in adult coeliac disease : An Italian multicentre study
Copyright © 2022 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved..
BACKGROUND: There are few data regarding the diagnostic delay and its predisposing factors in coeliac disease (CD).
AIMS: To investigate the overall, the patient-dependant, and the physician-dependant diagnostic delays in CD.
METHODS: CD adult patients were retrospectively enroled at 19 Italian CD outpatient clinics (2011-2021). Overall, patient-dependant, and physician-dependant diagnostic delays were assessed. Extreme diagnostic, i.e., lying above the third quartile of our population, was also analysed. Multivariable regression models for factors affecting the delay were fitted.
RESULTS: Overall, 2362 CD patients (median age at diagnosis 38 years, IQR 27-46; M:F ratio=1:3) were included. The median overall diagnostic delay was 8 months (IQR 5-14), while patient- and physician-dependant delays were 3 (IQR 2-6) and 4 (IQR 2-6) months, respectively. Previous misdiagnosis was associated with greater physician-dependant (1.076, p = 0.005) and overall (0.659, p = 0.001) diagnostic delays. Neurological symptoms (odds ratio 2.311, p = 0.005) and a previous misdiagnosis (coefficient 9.807, p = 0.000) were associated with a greater extreme physician-dependant delay. Gastrointestinal symptoms (OR 1.880, p = 0.004), neurological symptoms (OR 2.313, p = 0.042), and previous misdiagnosis (OR 4.265, p = 0.000) were associated with increased extreme overall diagnostic delay.
CONCLUSION: We identified some factors that hamper CD diagnosis. A proper screening strategy for CD should be implemented.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:55 |
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| Enthalten in: |
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver - 55(2023), 6 vom: 23. Juni, Seite 743-750 |
| Sprache: |
Englisch |
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| Links: |
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| Themen: |
Diagnosis |
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| Anmerkungen: |
Date Completed 29.05.2023 Date Revised 20.07.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.dld.2022.11.021 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM350786674 |
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| 100 | 1 | |a Lenti, Marco Vincenzo |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Diagnostic delay in adult coeliac disease |b An Italian multicentre study |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 29.05.2023 | ||
| 500 | |a Date Revised 20.07.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved. | ||
| 520 | |a BACKGROUND: There are few data regarding the diagnostic delay and its predisposing factors in coeliac disease (CD) | ||
| 520 | |a AIMS: To investigate the overall, the patient-dependant, and the physician-dependant diagnostic delays in CD | ||
| 520 | |a METHODS: CD adult patients were retrospectively enroled at 19 Italian CD outpatient clinics (2011-2021). Overall, patient-dependant, and physician-dependant diagnostic delays were assessed. Extreme diagnostic, i.e., lying above the third quartile of our population, was also analysed. Multivariable regression models for factors affecting the delay were fitted | ||
| 520 | |a RESULTS: Overall, 2362 CD patients (median age at diagnosis 38 years, IQR 27-46; M:F ratio=1:3) were included. The median overall diagnostic delay was 8 months (IQR 5-14), while patient- and physician-dependant delays were 3 (IQR 2-6) and 4 (IQR 2-6) months, respectively. Previous misdiagnosis was associated with greater physician-dependant (1.076, p = 0.005) and overall (0.659, p = 0.001) diagnostic delays. Neurological symptoms (odds ratio 2.311, p = 0.005) and a previous misdiagnosis (coefficient 9.807, p = 0.000) were associated with a greater extreme physician-dependant delay. Gastrointestinal symptoms (OR 1.880, p = 0.004), neurological symptoms (OR 2.313, p = 0.042), and previous misdiagnosis (OR 4.265, p = 0.000) were associated with increased extreme overall diagnostic delay | ||
| 520 | |a CONCLUSION: We identified some factors that hamper CD diagnosis. A proper screening strategy for CD should be implemented | ||
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Diagnosis | |
| 650 | 4 | |a Enteropathy | |
| 650 | 4 | |a Gluten | |
| 650 | 4 | |a Malabsorption | |
| 650 | 4 | |a Villi | |
| 700 | 1 | |a Aronico, Nicola |e verfasserin |4 aut | |
| 700 | 1 | |a Bianchi, Paola Ilaria |e verfasserin |4 aut | |
| 700 | 1 | |a D'Agate, Carmela Cinzia |e verfasserin |4 aut | |
| 700 | 1 | |a Neri, Matteo |e verfasserin |4 aut | |
| 700 | 1 | |a Volta, Umberto |e verfasserin |4 aut | |
| 700 | 1 | |a Mumolo, Maria Gloria |e verfasserin |4 aut | |
| 700 | 1 | |a Astegiano, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Calabrò, Antonino Salvatore |e verfasserin |4 aut | |
| 700 | 1 | |a Zingone, Fabiana |e verfasserin |4 aut | |
| 700 | 1 | |a Latella, Giovanni |e verfasserin |4 aut | |
| 700 | 1 | |a Di Sario, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Carroccio, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Ciacci, Carolina |e verfasserin |4 aut | |
| 700 | 1 | |a Luzza, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Bagnato, Carmela |e verfasserin |4 aut | |
| 700 | 1 | |a Fantini, Massimo Claudio |e verfasserin |4 aut | |
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| 700 | 1 | |a Gasbarrini, Antonio |e verfasserin |4 aut | |
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| 700 | 1 | |a Latorre, Mario Andrea |e verfasserin |4 aut | |
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