Evidence map›Paper›PMID 29934381›Full record

SynthesisBMJ open2018

Quantifying intervals to diagnosis in myeloma: a systematic review and meta-analysis.

Constantinos Koshiaris, Jason Oke, Lucy Abel, Brian D Nicholson, Karthik Ramasamy, Ann Van den Bruel

Registry-linked trialAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05539079 (A Prospective Long-term Observational Study in Patients With Monoclonal Gammopathy of Undetermined Significance), which is not on this map. Cited by 24 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT05539079 recruitingnot on this mapstarted 2023, after this paper: background citation

A Prospective Long-term Observational Study in Patients With Monoclonal Gammopathy of Undetermined Significance

TypeobservationalSponsorOxford University Hospitals NHS TrustRan2023 to 2032Enrolled2,000ConditionsMGUS
3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Review
  6. Review
  7. Review
  8. Article
  9. Article
  10. Article
  11. Review
  12. Article
  13. Article
  14. Article
  15. Medical practitioners' knowledge and awareness of multiple myeloma at public hospitals, Gauteng, South Africa.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2023
    Article
  16. Review
  17. Article
  18. Building the case for the use of gut feelings in cancer referrals: perspectives of patients referred to a non-specific symptoms pathway.The British journal of general practice : the journal of the Royal College of General Practitioners · 2022
    Article
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Constantinos KoshiarisNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Jason OkeNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Lucy AbelNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Brian D NicholsonNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Karthik RamasamyDepartment of Haematology, Oxford University Hospitals NHS Trust, Oxford, UK.
Ann Van den BruelNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo quantify the duration of each step of the diagnostic pathway for patients with multiple myeloma from symptom onset to confirmation of diagnosis.

designSystematic review and meta-analysis. DATA SOURCES AND SELECTION CRITERIA: The MEDLINE and Embase databases were searched up until January 2018 to identify articles that reported time intervals from onset of symptoms to diagnosis. Articles focusing on children or adolescents and on the asymptomatic form of the disease (monoclonal gammopathies and smouldering myeloma) were excluded. DATA COLLECTION AND DATA ANALYSIS: Data were extracted independently by two reviewers. Weighted estimates of the median and IQR were calculated. Risk of bias was assessed using the Aarhus checklist. MAIN

resultsNine studies were included. The patient interval (first symptom to first presentation) had a median of 26.3 days (IQR: 1-98, n=465, two studies). Subsequently, the primary care interval (first presentation to first referral) was 21.6 days (IQR: 4.6-55.8, n=326, two studies), the diagnostic interval (first presentation to diagnosis) was 108.6 days (IQR: 33.3-241.7, n=5395, seven studies) and the time to diagnosis (first symptom to diagnosis) interval was 163 days (IQR: 84-306, n=341, one study). No studies reported data for the referral to diagnosis interval.

conclusionThe review demonstrates that there is scope for significant reductions in the time to myeloma diagnosis. At present, many patients experience a diagnostic interval longer than 3 months until diagnosis is confirmed. REVIEW REGISTRATION: Not available. Protocol available in the appendix.

Indexed as

HumansMultiple MyelomaPrimary Health CareReferral and ConsultationTime Factorsdelaysearly diagnosismultiple myelomaprimary caresystematic reviewtime to diagnosis

Identifiers

PMID29934381
PMCPMC6020959

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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.