Aymane Ajbar1, Eleanor Cross2, Simbarashe Matoi1, Charles A Hay2, Libby M Baines2, Benjamin Saunders2, Adam D Farmer2,3, James A Prior4,5. 1. Royal College of Surgeons in Ireland, Medical University of Bahrain, Busaiteen, Bahrain. 2. School of Medicine, Keele University, Staffordshire, ST5 5BG, UK. 3. Department of Gastroenterology, University Hospital of North Midlands (UHNM) NHS Trust, Stoke-on-Trent, UK. 4. School of Medicine, Keele University, Staffordshire, ST5 5BG, UK. j.a.prior@keele.ac.uk. 5. Midlands Partnership NHS Foundation Trust, Trust Headquarters, St. George's Hospital, Stafford, UK. j.a.prior@keele.ac.uk.
Abstract
INTRODUCTION: Delays in diagnosing pediatric inflammatory bowel disease (IBD) are common, but the extent of this delay remains unclear due to variations in reported time-periods between studies. The objectives of this systematic review were to examine the extent of diagnostic delay in pediatric IBD and examine any association between specific characteristics and length of diagnostic delay. METHODS: We identified studies from several medical bibliographical databases (EMBASE, Medline and CINAHL) from their inception to April 2021. Studies examining pediatric cohorts (< 18 years old) defined as having a diagnosis of Crohn's Disease (CD), ulcerative colitis (UC), or by the more general definition of IBD, and reporting a median time-period between the onset of symptoms and a final diagnosis (diagnostic delay) were included. Two reviewers selected each study, extracted data, and assessed their quality using the Newcastle-Ottawa scale. Narrative synthesis was then used to examine the extent of overall diagnostic delay and delay associated with specific sample characteristics. RESULTS: Of the 10,119 studies initially identified, 24 were included in the review. The overall median diagnostic delay range was 2-10.4 months for IBD, 2.0-18.0 months for UC and 4.0-24.0 months for CD. However, for approximately two thirds of UC (68.8%) and CD (66.7%) studies, delay ranged from 2.0-3.0 and 4.0-6.3 months, respectively. A longer delay was significantly associated with several sample characteristics; however, these were too infrequently examined to draw robust conclusion on their role. CONCLUSION: Children continue to wait several months for a final diagnosis of IBD, and those with CD experience longer delay than those with UC. The role of specific characteristics on delay needs further exploration.
INTRODUCTION: Delays in diagnosing pediatric inflammatory bowel disease (IBD) are common, but the extent of this delay remains unclear due to variations in reported time-periods between studies. The objectives of this systematic review were to examine the extent of diagnostic delay in pediatric IBD and examine any association between specific characteristics and length of diagnostic delay. METHODS: We identified studies from several medical bibliographical databases (EMBASE, Medline and CINAHL) from their inception to April 2021. Studies examining pediatric cohorts (< 18 years old) defined as having a diagnosis of Crohn's Disease (CD), ulcerative colitis (UC), or by the more general definition of IBD, and reporting a median time-period between the onset of symptoms and a final diagnosis (diagnostic delay) were included. Two reviewers selected each study, extracted data, and assessed their quality using the Newcastle-Ottawa scale. Narrative synthesis was then used to examine the extent of overall diagnostic delay and delay associated with specific sample characteristics. RESULTS: Of the 10,119 studies initially identified, 24 were included in the review. The overall median diagnostic delay range was 2-10.4 months for IBD, 2.0-18.0 months for UC and 4.0-24.0 months for CD. However, for approximately two thirds of UC (68.8%) and CD (66.7%) studies, delay ranged from 2.0-3.0 and 4.0-6.3 months, respectively. A longer delay was significantly associated with several sample characteristics; however, these were too infrequently examined to draw robust conclusion on their role. CONCLUSION: Children continue to wait several months for a final diagnosis of IBD, and those with CD experience longer delay than those with UC. The role of specific characteristics on delay needs further exploration.
Authors: Thomas Greuter; Fabio Bertoldo; Roman Rechner; Alex Straumann; Luc Biedermann; Jonas Zeitz; Benjamin Misselwitz; Michael Scharl; Gerhard Rogler; Ekaterina Safroneeva; Raja A R Ali; Christian Braegger; Klaas Heyland; Pascal Mueller; Andreas Nydegger; Laetitia-Marie Petit; Susanne Schibli; Raoul I Furlano; Johannes Spalinger; Michela Schäppi; Samuel Zamora; Florian Froehlich; Denise Herzog; Alain M Schoepfer; Stephan R Vavricka Journal: J Pediatr Gastroenterol Nutr Date: 2017-08 Impact factor: 2.839
Authors: Omar I Saadah; Mohammad El Mouzan; Mohammad Al Mofarreh; Ali Al Mehaidib; Mohammad Al Edreesi; Mohammed Hasosah; Abdulrahman Al-Hussaini; Khalid AlSaleem Journal: Gastroenterol Res Pract Date: 2015-12-29 Impact factor: 2.260