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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| Format: | Article |
| Language: | English |
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MDPI AG
2022-04-01
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| Series: | Journal of Fungi |
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| Online Access: | https://www.mdpi.com/2309-608X/8/5/438 |
| _version_ | 1827668372621361152 |
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| author | Aaron C. Miller Alan T. Arakkal Scott H. Koeneman Joseph E. Cavanaugh George R. Thompson John W. Baddley Philip M. Polgreen |
| author_facet | Aaron C. Miller Alan T. Arakkal Scott H. Koeneman Joseph E. Cavanaugh George R. Thompson John W. Baddley Philip M. Polgreen |
| author_sort | Aaron C. Miller |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-03-10T03:37:59Z |
| format | Article |
| id | doaj.art-c8e6ba65c8b84386ac1c573f8d668f83 |
| institution | Directory Open Access Journal |
| issn | 2309-608X |
| language | English |
| last_indexed | 2024-03-10T03:37:59Z |
| publishDate | 2022-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Fungi |
| spelling | doaj.art-c8e6ba65c8b84386ac1c573f8d668f832023-11-23T11:41:03ZengMDPI AGJournal of Fungi2309-608X2022-04-018543810.3390/jof8050438Frequency and Duration of, and Risk Factors for, Diagnostic Delays Associated with HistoplasmosisAaron C. Miller0Alan T. Arakkal1Scott H. Koeneman2Joseph E. Cavanaugh3George R. Thompson4John W. Baddley5Philip M. Polgreen6Department of Internal Medicine, University of Iowa, Iowa City, IA 52242, USADepartment of Biostatistics, University of Iowa, Iowa City, IA 52242, USADepartment of Biostatistics, University of Iowa, Iowa City, IA 52242, USADepartment of Biostatistics, University of Iowa, Iowa City, IA 52242, USADepartment of Medicine, University of California, Davis, CA 95616, USADepartment of Medicine, University of Maryland, Baltimore, MD 21201, USADepartments of Internal Medicine and Epidemiology, University of Iowa, Iowa City, IA 52242, USAHistoplasmosis 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.https://www.mdpi.com/2309-608X/8/5/438histoplasmosisdiagnostic delaysdiagnostic errors |
| spellingShingle | Aaron C. Miller Alan T. Arakkal Scott H. Koeneman Joseph E. Cavanaugh George R. Thompson John W. Baddley Philip M. Polgreen Frequency and Duration of, and Risk Factors for, Diagnostic Delays Associated with Histoplasmosis Journal of Fungi histoplasmosis diagnostic delays diagnostic errors |
| 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 | histoplasmosis diagnostic delays diagnostic errors |
| url | https://www.mdpi.com/2309-608X/8/5/438 |
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