Evidence map›Paper›PMID 37453028›Full record

ReviewClinical rheumatology2023

Prevalence and adverse consequences of delayed diagnosis and misdiagnosis in thrombotic antiphospholipid syndrome. An observational cohort study and a review of the literature.

Amelia Ruffatti, Marta Tonello, Antonia Calligaro, Teresa Del Ross, Maria Favaro, Margherita Zen, Ariela Hoxha, Mauro Alaibac

Open access · hybridAbstract readReview
In one paragraph

Review in Clinical rheumatology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.2field-weighted citation impact, top 12% of its field
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Article
  3. 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

8 authors at 1 institution in 1 country.

Amelia RuffattiDepartment of Medicine-DIMED, University Hospital of Padua, Padua, Italy. amelia.ruffatti@unipd.it.ORCID http://orcid.org/0000-0003-1391-9828
Marta TonelloDepartment of Medicine-DIMED, Rheumatology Unit, University Hospital of Padua, Padua, Italy.ORCID http://orcid.org/0000-0001-9826-4079
Antonia CalligaroDepartment of Medicine-DIMED, Rheumatology Unit, University Hospital of Padua, Padua, Italy.
Teresa Del RossDepartment of Medicine-DIMED, Rheumatology Unit, University Hospital of Padua, Padua, Italy.
Maria FavaroDepartment of Medicine-DIMED, Rheumatology Unit, University Hospital of Padua, Padua, Italy.
Margherita ZenDepartment of Medicine-DIMED, Rheumatology Unit, University Hospital of Padua, Padua, Italy.ORCID http://orcid.org/0000-0003-0835-1406
Ariela HoxhaDepartment of Medicine-DIMED, General Internal Medicine Unit, Thrombotic and Hemorrhagic Disease Unit, University Hospital of Padua, Padua, Italy.ORCID http://orcid.org/0000-0001-7741-6432
Mauro AlaibacDepartment of Medicine-DIMED, Dermatology Unit, University Hospital of Padua, Padua, Italy.ORCID http://orcid.org/0000-0001-6524-4848
University of Padua · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

obiectivesThis study aims to prospectively evaluate the frequency and adverse consequences of diagnostic delay and misdiagnosis in a cohort of patients with thrombotic antiphospholipid syndrome (TAPS). In addition, a systematic review of the literature concerning the diagnostic delay and misdiagnosis of TAPS was carried out.

methodsPatient enrollment occurred between 1999 and 2022. The study group was formed by TAPS patients whose diagnosis was delayed and those who were misdiagnosed. The control group was made up of patients who were timely and correctly diagnosed with TAPS.

resultsThe literature review showed 42 misdiagnosed patients, 27 of them were in one retrospective cohort study and 15 in 13 case reports. One hundred sixty-one out of 189 patients (85.2%) received a timely, correct diagnosis of TAPS; 28 (14.8%) did not. The number of patients with diagnostic issues was significantly higher for the first period (1999-2010), and the number of patients with a correct diagnosis was significantly higher for the second one (2011-2022). When the clinical and laboratory characteristics of the patients with delayed diagnosis were compared with those with misdiagnosis, there was a significantly higher number of severe adverse consequences characterized by permanent disability or death in the latter group. The two most common types of misdiagnoses were systemic lupus erythematosus (6 cases, 46.1%) and cardiovascular diseases (4 cases, 30.8%).

conclusionsThe study demonstrates that although knowledge about TAPS has improved over time, diagnostic delays and errors remains to be addressed as they are strongly associated to adverse consequences. Key Points •Although knowledge of thrombotic antiphospholipid syndrome has improved over time, it is still limited. •Diagnostic delay and misdiagnosis are still an important issue that remains to be addressed as they are strongly associated to adverse consequences. •The three more frequent misdiagnoses are multiple sclerosis, systemic lupus erythematosus and cardiovascular diseases.

Indexed as

Antiphospholipid SyndromeCardiovascular DiseasesLupus Erythematosus, SystemicThrombosisCohort StudiesDelayed DiagnosisDiagnostic ErrorsHumansPrevalenceRetrospective StudiesAdverse consequencesAntiphospholipid syndromeDiagnostic delayMisdiagnosisThrombotic antiphospholipid syndrome

Identifiers

PMID37453028
PMCPMC10587197
OpenAlexW4384407896

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.