ArticleBMJ open2018
Challenges of diagnosis and management of giant cell arteritis in general practice: a multimethods study.
Article in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 21 citations in OpenAlex.
- Treat-to-target recommendations in giant cell arteritis and polymyalgia rheumatica.Annals of the rheumatic diseases · 2024Pooled it
- European Headache Federation recommendations for neurologists managing giant cell arteritis.The journal of headache and pain · 2020Pooled it
- Understanding the patient experience of newly diagnosed giant cell arteritis.Rheumatology advances in practice · 2026Article
- Investigating interferon type I responses in patients with suspected giant cell arteritis and polymyalgia rheumatica.Clinical and experimental immunology · 2024Article
- Diagnostic delay in patients with giant cell arteritis: results of a fast-track clinic.Clinical rheumatology · 2024Article
- Distinguishing laboratory characteristics in giant cell arteritis: a real-world retrospective cohort study.International ophthalmology · 2023Article
- Atypical giant cell arteritis presentations diagnosed with FDG-18 whole body PET imaging.BMJ case reports · 2023Article
- Common co-morbidities in polymyalgia rheumatica and giant cell arteritis: cross-sectional study in UK Biobank.Rheumatology advances in practice · 2023Article
- Beyond Giant Cell Arteritis and Takayasu's Arteritis: Secondary Large Vessel Vasculitis and Vasculitis Mimickers.Current rheumatology reports · 2020Review
- Fast-Track Ultrasound Clinic for the Diagnosis of Giant Cell Arteritis Changes the Prognosis of the Disease but Not the Risk of Future Relapse.Frontiers in medicine · 2020Article
- Giant cell arteritis: is the clinical spectrum of the disease changing?BMC geriatrics · 2019Review
- Reviewing the Pathophysiology Behind the Advances in the Management of Giant Cell Arteritis.Ophthalmology and therapy · 2019Review
- Examining management and research priorities in patients with polymyalgia rheumatica: a primary care questionnaire survey.Clinical rheumatology · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
backgroundIn the UK, general practitioners (GPs) are usually the first medical contact for patients with suspected giant cell arteritis (GCA). While rare, it is critical not to miss, as delayed treatment can lead to significant complications including permanent visual loss. To date, little is known about the approach and challenges to diagnosis and management of GCA by GPs.
objectiveTo investigate the diagnosis and management of patients with suspected GCA in UK general practice. DESIGN AND
participantsA multimethods approach was taken, comprising a postal survey of 5000 randomly selected UK GPs and semistructured telephone interviews of 24 GPs from across the UK.
settingUK general practice.
results1249 questionnaires were returned. 879 responders (70%) indicated that they had diagnosed and managed a patient with GCA. A variety of clinical features were used to identify GCA. 21.9% suggested that they would exclude GCA as a diagnosis if headache was absent and around one-third do not routinely initiate glucocorticoid treatment prior to referral. Significant regional variations in referral pathways were reported. Thematic analysis of interview transcripts highlighted fears relating to a missed diagnosis of GCA and the non-specific nature of early GCA presentation. Accessing specialist care was highlighted as challenging by many GPs and that a national standard fast-track pathway is lacking to support this patient group. Additionally there were significant concerns regarding potential adverse effects relating to long-term treatment with glucocorticoids.
conclusionGPs appear to over-rely on headache to identify GCA and marked geographical differences in management, with conflicting referral pathways and difficulties in accessing appropriate services exist in the UK. A national standard for fast-tracking patients with suspected GCA to relevant specialists would be beneficial to improve care and outcomes for patients with GCA.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.