Diagnostic delay for giant cell arteritis - a systematic review and meta-analysis

Area of Science:

• Rheumatology
• Vascular Medicine
• Clinical Epidemiology

Background:

• Giant cell arteritis (GCA) is a serious condition that can lead to blindness and stroke if not treated promptly.
• Understanding diagnostic delay is crucial for improving patient outcomes in GCA.
• Previous benchmarks for GCA diagnostic delay were lacking evidence-based support.

Purpose of the Study:

• To establish an evidence-based benchmark for the diagnostic delay in Giant cell arteritis (GCA).
• To investigate how GCA-specific characteristics influence the time to diagnosis.

Main Methods:

• A systematic literature search was conducted on medical databases up to November 2015.
• Random-effects meta-analysis was employed to pool data on diagnostic delay from selected studies.
• Study quality was assessed, and data on GCA symptom onset to diagnosis timeframes were extracted.

Main Results:

• The meta-analysis included 16 studies, revealing a mean diagnostic delay of 9.0 weeks for GCA (95% CI, 6.5 to 11.4).
• Patients presenting with cranial symptoms experienced a mean diagnostic delay of 7.7 weeks.
• Those with non-cranial GCA presentations faced a significantly longer mean delay of 17.6 weeks.

Conclusions:

• The established mean diagnostic delay for GCA is 9 weeks, increasing substantially when cranial symptoms are absent.
• This research provides a critical evidence-based benchmark for GCA diagnostic delay.
• Findings underscore the necessity for enhanced public awareness and expedited diagnostic pathways for GCA.