Systematic Evaluation of Diagnostic Delay in Pediatric Inflammatory Bowel Disease
Alain M Schoepfer1, Stephan Vavricka, Ekaterina Safroneeva
1*Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois et Université de Lausanne, Lausanne †Division of Gastroenterology and Hepatology, Triemlispital ‡Division of Gastroenterology and Hepatology, University Hospital Zurich, Zurich §Institute of Social and Preventive Medicine, University of Bern, Bern ||Institute of Social and Preventive Medicine, Centre Hospitalier Universitaire Vaudois et Université de Lausanne, Lausanne ¶Division of Gastroenterology and Hepatology, University Hospital Basel, Basel #Division of Pediatric Gastroenterology and Nutrition, Centre Hospitalier Universitaire Vaudois et Université de Lausanne, Lausanne **Division of Gastroenterology and Nutrition ††Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland.
Insights
Pediatric Crohn disease (CD) patients experienced longer diagnostic delays (4 months) than ulcerative colitis (UC) patients (2 months). Further investigation is needed to reduce delays in diagnosing these inflammatory bowel diseases.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
Background:
- Diagnostic delay is a significant concern in pediatric inflammatory bowel disease (IBD).
- Understanding delays in Crohn disease (CD) and ulcerative colitis (UC) is crucial for timely intervention.
Purpose of the Study:
- To evaluate and compare the diagnostic delay in pediatric patients diagnosed with Crohn disease (CD) and ulcerative colitis (UC).
Main Methods:
- Retrospective analysis of diagnostic timelines for 100 pediatric CD patients and 75 pediatric UC patients.
- Comparison of time from symptom onset to diagnosis between CD and UC cohorts.
- Analysis of time intervals from symptom onset to first physician visit versus first physician visit to diagnosis.
Main Results:
- Median diagnostic delay was significantly longer in pediatric CD (4 months) compared to UC (2 months) (P=0.003).
- The interval from the first physician visit to diagnosis was longer than the interval from symptom onset to the first physician visit for both CD and UC.
- No specific risk factors were identified for prolonged diagnostic delays in either condition.
Conclusions:
- Pediatric Crohn disease exhibits a longer diagnostic delay than ulcerative colitis.
- Efforts to shorten the diagnostic pathway, particularly the time from symptom onset to initial medical consultation, are warranted for both conditions.
- Further research is needed to identify specific factors contributing to diagnostic delay to inform targeted interventions.
Abstract:
We evaluated the diagnostic delay (time from first symptoms to diagnosis) in 100 pediatric patients with Crohn disease (CD) and 75 patients with ulcerative colitis (UC). Median (interquartile range) diagnostic delay in patients with CD was 4 (2-8) (range 0-82) months compared with 2 (1-7) (range 0-52) months in patients with UC (P = 0.003). The time interval from first physician visit to inflammatory bowel disease diagnosis was longer in patients with CD and UC when compared to the time interval from symptom onset to first physician visit (CD: median 3 vs 1 months, P < 0.001; UC: median 2 vs 0 months, P < 0.001). No specific risk factors were identified for the length of diagnostic delay. Measures should be taken to reduce diagnostic delay.
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