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Frequency and Duration of, and Risk Factors for, Diagnostic Delays Associated with Histoplasmosis

Histoplasmosis is often confused with other diseases leading to diagnostic delays. We estimated the incidence, length of, and risk factors for, diagnostic delays associated with histoplasmosis. Using data from IBM Marketscan, 2001–2017, we found all patients with a histoplasmosis diagnosis. We calcu...

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Autores principales: Miller, Aaron C., Arakkal, Alan T., Koeneman, Scott H., Cavanaugh, Joseph E., Thompson, George R., Baddley, John W., Polgreen, Philip M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9143509/
https://www.ncbi.nlm.nih.gov/pubmed/35628693
http://dx.doi.org/10.3390/jof8050438
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author Miller, Aaron C.
Arakkal, Alan T.
Koeneman, Scott H.
Cavanaugh, Joseph E.
Thompson, George R.
Baddley, John W.
Polgreen, Philip M.
author_facet Miller, Aaron C.
Arakkal, Alan T.
Koeneman, Scott H.
Cavanaugh, Joseph E.
Thompson, George R.
Baddley, John W.
Polgreen, Philip M.
author_sort Miller, Aaron C.
collection PubMed
description Histoplasmosis is often confused with other diseases leading to diagnostic delays. We estimated the incidence, length of, and risk factors for, diagnostic delays associated with histoplasmosis. Using data from IBM Marketscan, 2001–2017, we found all patients with a histoplasmosis diagnosis. We calculated the number of visits that occurred prior to the histoplasmosis diagnosis and the number of visits with symptomatically similar diagnoses (SSDs). Next, we estimated the number of visits that represented a delay using a simulation-based approach. We also computed the number of potential opportunities for diagnosis that were missed for each patient and the length of time between the first opportunity and the diagnosis. Finally, we identified risk factors for diagnostic delays using a logistic regression model. The number of SSD-related visits increased significantly in the 97 days prior to the histoplasmosis diagnosis. During this period, 97.4% of patients had a visit, and 90.1% had at least one SSD visit. We estimate that 82.9% of patients with histoplasmosis experienced at least one missed diagnostic opportunity. The average delay was 39.5 days with an average of 4.0 missed opportunities. Risk factors for diagnostic delays included prior antibiotic use, history of other pulmonary diseases, and emergency department and outpatient visits, especially during weekends. New diagnostic approaches for histoplasmosis are needed.
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spelling pubmed-91435092022-05-29 Frequency and Duration of, and Risk Factors for, Diagnostic Delays Associated with Histoplasmosis Miller, Aaron C. Arakkal, Alan T. Koeneman, Scott H. Cavanaugh, Joseph E. Thompson, George R. Baddley, John W. Polgreen, Philip M. J Fungi (Basel) Article Histoplasmosis is often confused with other diseases leading to diagnostic delays. We estimated the incidence, length of, and risk factors for, diagnostic delays associated with histoplasmosis. Using data from IBM Marketscan, 2001–2017, we found all patients with a histoplasmosis diagnosis. We calculated the number of visits that occurred prior to the histoplasmosis diagnosis and the number of visits with symptomatically similar diagnoses (SSDs). Next, we estimated the number of visits that represented a delay using a simulation-based approach. We also computed the number of potential opportunities for diagnosis that were missed for each patient and the length of time between the first opportunity and the diagnosis. Finally, we identified risk factors for diagnostic delays using a logistic regression model. The number of SSD-related visits increased significantly in the 97 days prior to the histoplasmosis diagnosis. During this period, 97.4% of patients had a visit, and 90.1% had at least one SSD visit. We estimate that 82.9% of patients with histoplasmosis experienced at least one missed diagnostic opportunity. The average delay was 39.5 days with an average of 4.0 missed opportunities. Risk factors for diagnostic delays included prior antibiotic use, history of other pulmonary diseases, and emergency department and outpatient visits, especially during weekends. New diagnostic approaches for histoplasmosis are needed. MDPI 2022-04-23 /pmc/articles/PMC9143509/ /pubmed/35628693 http://dx.doi.org/10.3390/jof8050438 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Miller, Aaron C.
Arakkal, Alan T.
Koeneman, Scott H.
Cavanaugh, Joseph E.
Thompson, George R.
Baddley, John W.
Polgreen, Philip M.
Frequency and Duration of, and Risk Factors for, Diagnostic Delays Associated with Histoplasmosis
title Frequency and Duration of, and Risk Factors for, Diagnostic Delays Associated with Histoplasmosis
title_full Frequency and Duration of, and Risk Factors for, Diagnostic Delays Associated with Histoplasmosis
title_fullStr Frequency and Duration of, and Risk Factors for, Diagnostic Delays Associated with Histoplasmosis
title_full_unstemmed Frequency and Duration of, and Risk Factors for, Diagnostic Delays Associated with Histoplasmosis
title_short Frequency and Duration of, and Risk Factors for, Diagnostic Delays Associated with Histoplasmosis
title_sort frequency and duration of, and risk factors for, diagnostic delays associated with histoplasmosis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9143509/
https://www.ncbi.nlm.nih.gov/pubmed/35628693
http://dx.doi.org/10.3390/jof8050438
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