Factors associated with diagnostic delay and specialty consultation patterns in systemic sclerosis: A cross-sectional...

Area of Science:

• Rheumatology
• Autoimmune Diseases
• Clinical Diagnosis

Background:

• Systemic Sclerosis (SSc) diagnosis is challenging due to nonspecific symptoms and overlap with other autoimmune conditions.
• Early detection of SSc is crucial for effective management and improved patient outcomes.
• Current diagnostic pathways for SSc often involve significant delays.

Purpose of the Study:

• To investigate factors contributing to diagnostic delays in Systemic Sclerosis.
• To analyze the number and types of physician specialties consulted before an SSc diagnosis.
• To identify patient and referral characteristics associated with the time to SSc diagnosis.

Main Methods:

• A cross-sectional study involving 135 Systemic Sclerosis patients at a university rheumatology clinic.
• Data collection included demographics, clinical features, and physician consultations via interviews.
• Statistical analysis identified factors associated with the number of pre-diagnostic consultations.

Main Results:

• Median time to SSc diagnosis was 36 months from Raynaud's phenomenon onset and 11 months from the first non-Raynaud's symptom.
• Limited SSc patients experienced longer diagnostic delays compared to diffuse SSc patients (44 vs. 20 months).
• Patients consulted a median of 3 physicians (range 1-9) before diagnosis; only 6.7% were diagnosed at the first visit.

Conclusions:

• Systemic Sclerosis diagnosis is frequently delayed, necessitating multiple physician consultations.
• Higher education levels and referrals from familiar healthcare professionals were linked to fewer consultations.
• Enhanced physician awareness and prompt rheumatology referrals are vital for reducing SSc diagnostic delays.