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Aiming for a shorter time to diagnosis: pediatric eosinophilic esophagitis in British Columbia
Jocelyn Jia1,2, Edmond S Chan2,3, Vishal Avinashi2,4
1Faculty of Medicine, University of Toronto, Toronto, ON Canada.
Insights
Diagnosing eosinophilic esophagitis in Canadian children took a median of 21 months, with Caucasian children and older diagnosed patients experiencing longer delays. These delays impact patient outcomes and require further investigation.
Area of Science:
- Pediatric Gastroenterology
- Immunology
- Public Health
Background:
- Eosinophilic esophagitis (EoE) diagnosis delays can negatively impact patient outcomes.
- Quantifying diagnostic delay in Canadian pediatric EoE patients is lacking.
- Understanding factors influencing diagnostic timelines is crucial for improving care.
Purpose of the Study:
- To determine the time to diagnosis (TTD) for pediatric eosinophilic esophagitis in British Columbia.
- To identify predictors of increased TTD in this population.
Main Methods:
- Retrospective cohort study analyzing TTD for pediatric EoE patients.
- Statistical analysis to identify demographic and clinical factors associated with TTD.
- Regression modeling to predict increased diagnostic delay.
Main Results:
- The median TTD was 21 months (IQR: 7-45 months).
- Caucasian ethnicity and older age at diagnosis were significant predictors of longer TTD (p<0.05).
- Caucasian patients had a median TTD of 24 months compared to 12 months for other ethnicities.
Conclusions:
- Significant diagnostic delays exist for pediatric eosinophilic esophagitis in British Columbia.
- Caucasian ethnicity and older age are key factors contributing to these delays.
- Further research is needed to address disparities and shorten TTD for improved pediatric EoE patient outcomes.
Abstract:
Longer time to diagnosis for patients with eosinophilic esophagitis can lead to adverse patient outcomes, but the length of diagnostic delay has not been quantified for patients with eosinophilic esophagitis in Canada. Our study defines the time to diagnosis (TTD) for pediatric patients with eosinophilic esophagitis in British Columbia and identifies factors that predict increased time to diagnosis. The median TTD was 21 months (1.75 years; IQR = 7, 45) with a median age at EoE diagnosis of 105 months (8.75 years; IQR = 44, 156). Caucasians experienced significantly longer TTD compared to other ethnicities (24 months (IQR = 7, 52) and 12 months (IQR = 4.5, 23) respectively, p = 0.008). Caucasian ethnicity (p = 0.037) and older age at the time of diagnosis (p = 0.006) predicted increased TTD. Our model explained 7.9% (Adjusted R2 = 0.079) of the total variance for our cohort.
