Dr. Gregory McDermott discusses the factors contributing to diagnostic delays in axial spondyloarthritis and the impact on treatment outcomes. The study examines delays in diagnosis, social vulnerability index, and challenges in improving diagnostic timelines despite evolving guidelines. The podcast also explores how a background in history shapes a junior physician-scientist's approach to medical research and future research topics in Axiospondyloarthritis.
Diagnostic delays in axial spondyloarthritis lead to extended suffering for patients, affecting treatment responses.
Social vulnerability and extra musculoskeletal manifestations like uveitis play significant roles in diagnostic delays.
Deep dives
Factors Associated with Diagnostic Delay in Axial Spondyloarthritis
Diagnostic delays in axial spondyloarthritis pose significant challenges, with patients enduring symptoms for an average of 6.7 years before diagnosis. This delay is linked to poorer treatment responses and increased disability. Identifying patients with inflammatory causes of low back pain is akin to finding a needle in a haystack, highlighting the complexity of diagnosing axial spondyloarthritis.
Hypotheses and Study Population
The study aimed to explore factors contributing to diagnostic delays, hypothesizing that patients displaying extra musculoskeletal manifestations like uveitis or psoriasis would have shorter delays. Additionally, the research investigated the correlation between diagnostic delay and area-level socioeconomic status. Utilizing electronic health records from Mass General Brigham Healthcare System, the study focused on patients diagnosed with axial spondyloarthritis within the healthcare system.
Social Vulnerability Index and Findings
The study revealed that a longer diagnostic delay was associated with a history of uveitis and higher social vulnerability index. Patients with a longer delay often presented with ankylosing spondylitis at diagnosis. Notably, social vulnerability findings persisted even after adjusting for clinical factors. Factors like peripheral arthritis and older age at symptom onset were linked to shorter diagnostic delays, indicating varied impacts on diagnostic timelines.
When disease strikes, time becomes a critical resource our patients cannot afford to waste. For those with axial spondyloarthritis (axSpA), an inordinate amount of time often goes by before a proper diagnosis is made, resulting in delays for crucial treatments to be rendered. The reasons for this delay in diagnosis, particularly among those with axSpA are diverse, complicated and not well-understood. Our guest, Dr. Gregory McDermott, attempted to better understand this diagnostic delay with his study: Factors Associated With Diagnostic Delay in Axial Spondyloarthritis: Impact of Clinical Factors and Social Vulnerability in hopes that we may begin answering these challenges with solutions.
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