Evidence map›Paper›PMID 38847994›Full record

ArticleRheumatology and therapy2024

Regional Differences in Diagnosis Journey and Healthcare Utilization: Results from the International Map of Axial Spondyloarthritis (IMAS).

Marco Garrido-Cumbrera, Denis Poddubnyy, Fernando Sommerfleck, Christine Bundy, Souzi Makri, José Correa-Fernández, Shashank Akerkar, Jo Lowe, Elie Karam, Victoria Navarro-Compán

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Article in Rheumatology and therapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing 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

5 citing papers in PubMed.

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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

10 authors.

Marco Garrido-CumbreraUniversidad de Sevilla, Health & Territory Research (HTR), Seville, Spain. mcumbrera@us.es.ORCID http://orcid.org/0000-0001-9727-1189
Denis PoddubnyyCharité-Universitätsmedizin Berlin, Berlin, Germany.ORCID https://orcid.org/0000-0002-4537-6015
Fernando SommerfleckSanatorio Julio Mendez, Buenos Aires, Argentina.
Christine BundyCardiff University, Cardiff, UK.ORCID https://orcid.org/0000-0002-5981-3984
Souzi MakriCyprus League for People with Rheumatism (CYLPER), Nicosia, Cyprus.
José Correa-FernándezUniversidad de Sevilla, Health & Territory Research (HTR), Seville, Spain.ORCID https://orcid.org/0000-0002-7788-5391
Shashank AkerkarMumbai Arthritis Clinic, Mumbai, India.
Jo LoweAxial Spondyloarthritis International Federation (ASIF), London, UK.
Elie KaramCanadian Spondylitis Association (CSA), Toronto, Canada.ORCID https://orcid.org/0000-0002-4681-8225
Victoria Navarro-CompánHospital Universitario La Paz, IdiPaz, Madrid, Spain.ORCID https://orcid.org/0000-0002-4527-852X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTo assess differences in the diagnosis journey and access to care in a large sample of patients with axial spondyloarthritis (axSpA) from around the world, included in the International Map of Axial Spondyloarthritis (IMAS).

methodsIMAS was a cross-sectional online survey (2017-2022) of 5557 unselected patients with axSpA from 27 countries. Across five worldwide geographic regions, the patient journey until diagnosis and healthcare utilization in the last 12 months prior to survey were evaluated. Univariable and multivariable linear regression was used to analyze factors associated with higher healthcare utilization.

resultsOf 5557 participants in IMAS, the diagnosis took an average of 7.4 years, requiring more than two visits to HCPs (77.7% general practitioner and 51.3% rheumatologist), and more than two diagnostic tests [67.5% performed human leukocyte antigen B27 (HLA-B27), 64.2% x-ray, and 59.1% magnetic resonance imaging (MRI) scans]. North America and Europe were the regions with the highest number of healthcare professional (HCP) visits for diagnosis, while the lowest number of visits was in the Asian region. In the previous 12 months, 94.9% (n = 5272) used at least one healthcare resource, with an average of 29 uses per year. The regions with the highest healthcare utilization were Latin America, Europe, and North America. In the multiple linear regression, factors associated with higher number of healthcare utilization were younger age (b =  - 0.311), female gender (b = 7.736), higher disease activity (b = 1.461), poorer mental health (b = 0.624), greater functional limitation (b = 0.300), greater spinal stiffness (b = 1.527), and longer diagnostic delay (b = 0.104).

conclusionThe diagnosis of axSpA usually takes more than two visits to HCPs and at least 7 years. After diagnosis, axSpA is associated with frequent healthcare resource use. Younger age, female gender, higher disease activity, poorer mental health, greater functional limitation, greater spinal stiffness, and longer diagnostic delay are associated with higher healthcare utilization. Europe and North America use more HCP visits and diagnostic tests before and after diagnosis than the other regions.

Indexed as

Access to careAxial spondyloarthritisDiagnosisHealthcareWorldwide

Identifiers

PMID38847994
PMCPMC11264652

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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.