Evidence map›Paper›PMID 38802264›Full record

ArticleBMJ open gastroenterology2024

Associations between prior healthcare use, time to diagnosis, and clinical outcomes in inflammatory bowel disease: a nationally representative population-based cohort study.

Nishani Jayasooriya, Sonia Saxena, Jonathan Blackwell, Alex Bottle, Hanna Creese, Irene Petersen, Richard C G Pollok, POP-IBD Collaboration

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open gastroenterology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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.

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

1 citing paper in PubMed.

  1. Article
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.

Nishani JayasooriyaInstitute for Infection and Immunity, St George's University of London, London, UK nishani.jayasooriya@nhs.net richard.pollok@nhs.net.ORCID 0000-0003-1343-2446
Sonia SaxenaDivision of Epidemiology, Public Health and Primary Care, Imperial College London, London, UK.
Jonathan BlackwellEdinburgh Inflammatory Bowel Disease, Western General Hospital, Edinburgh, UK.
Alex BottleDivision of Epidemiology, Public Health and Primary Care, Imperial College London, London, UK.ORCID 0000-0001-9978-2011
Hanna CreeseDivision of Epidemiology, Public Health and Primary Care, Imperial College London, London, UK.
Irene PetersenResearch Department of Primary Care and Population Health, University College London, London, UK.
Richard C G PollokInstitute for Infection and Immunity, St George's University of London, London, UK nishani.jayasooriya@nhs.net richard.pollok@nhs.net.ORCID 0000-0001-6452-6763
POP-IBD Collaboration

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTimely diagnosis and treatment of inflammatory bowel disease (IBD) may improve clinical outcomes.

objectiveExamine associations between time to diagnosis, patterns of prior healthcare use, and clinical outcomes in IBD.

designUsing the Clinical Practice Research Datalink we identified incident cases of Crohn's disease (CD) and ulcerative colitis (UC), diagnosed between January 2003 and May 2016, with a first primary care gastrointestinal consultation during the 3-year period prior to IBD diagnosis. We used multivariable Cox regression to examine the association of primary care consultation frequency (n=1, 2, >2), annual consultation intensity, hospitalisations for gastrointestinal symptoms, and time to diagnosis with a range of key clinical outcomes following diagnosis.

resultsWe identified 2645 incident IBD cases (CD: 782; UC: 1863). For CD, >2 consultations were associated with intestinal surgery (adjusted HR (aHR)=2.22, 95% CI 1.45 to 3.39) and subsequent CD-related hospitalisation (aHR=1.80, 95% CI 1.29 to 2.50). For UC, >2 consultations were associated with corticosteroid dependency (aHR=1.76, 95% CI 1.28 to 2.41), immunomodulator use (aHR=1.68, 95% CI 1.24 to 2.26), UC-related hospitalisation (aHR=1.43, 95% CI 1.05 to 1.95) and colectomy (aHR=2.01, 95% CI 1.22 to 3.27). For CD, hospitalisation prior to diagnosis was associated with CD-related hospitalisation (aHR=1.30, 95% CI 1.01 to 1.68) and intestinal surgery (aHR=1.71, 95% CI 1.13 to 2.58); for UC, it was associated with immunomodulator use (aHR=1.42, 95% CI 1.11 to 1.81), UC-related hospitalisation (aHR=1.36, 95% CI 1.06 to 1.95) and colectomy (aHR=1.54, 95% CI 1.01 to 2.34). For CD, consultation intensity in the year before diagnosis was associated with CD-related hospitalisation (aHR=1.19, 95% CI 1.12 to 1.28) and intestinal surgery (aHR=1.13, 95% CI 1.03 to 1.23); for UC, it was associated with corticosteroid use (aHR=1.08, 95% CI 1.04 to 1.13), corticosteroid dependency (aHR=1.05, 95% CI 1.00 to 1.11), and UC-related hospitalisation (aHR=1.12, 95% CI 1.03 to 1.21). For CD, time to diagnosis was associated with risk of CD-related hospitalisation (aHR=1.03, 95% CI 1.01 to 1.68); for UC, it was associated with reduced risk of UC-related hospitalisation (aHR=0.83, 95% CI 0.70 to 0.98) and colectomy (aHR=0.59, 95% CI 0.43 to 0.80).

conclusionElectronic records contain valuable information about patterns of healthcare use that can be used to expedite timely diagnosis and identify aggressive forms of IBD.

Indexed as

Colitis, UlcerativeCrohn DiseaseHospitalizationAdolescentAdultAgedCohort StudiesDelayed DiagnosisFemaleHumansMaleMiddle AgedPatient Acceptance of Health CarePrimary Health CareProportional Hazards ModelsReferral and ConsultationEPIDEMIOLOGYIBDIBD CLINICAL

Identifiers

PMID38802264
PMCPMC11131120

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.