Journal article
Frequency and Duration of, and Risk Factors for, Diagnostic Delays Associated with Histoplasmosis
Journal of fungi (Basel), Vol.8(5), p.438
01/01/2022
DOI: 10.3390/jof8050438
PMCID: PMC9143509
PMID: 35628693
Abstract
Histoplasmosis is often confused with other diseases leading to diagnostic delays. We estimated the incidence, length of, and risk factors for, diagnostic delays associated with histoplasmosis. Using data from IBM Marketscan, 2001–2017, we found all patients with a histoplasmosis diagnosis. We calculated the number of visits that occurred prior to the histoplasmosis diagnosis and the number of visits with symptomatically similar diagnoses (SSDs). Next, we estimated the number of visits that represented a delay using a simulation-based approach. We also computed the number of potential opportunities for diagnosis that were missed for each patient and the length of time between the first opportunity and the diagnosis. Finally, we identified risk factors for diagnostic delays using a logistic regression model. The number of SSD-related visits increased significantly in the 97 days prior to the histoplasmosis diagnosis. During this period, 97.4% of patients had a visit, and 90.1% had at least one SSD visit. We estimate that 82.9% of patients with histoplasmosis experienced at least one missed diagnostic opportunity. The average delay was 39.5 days with an average of 4.0 missed opportunities. Risk factors for diagnostic delays included prior antibiotic use, history of other pulmonary diseases, and emergency department and outpatient visits, especially during weekends. New diagnostic approaches for histoplasmosis are needed.
Details
- Title: Subtitle
- Frequency and Duration of, and Risk Factors for, Diagnostic Delays Associated with Histoplasmosis
- Creators
- Aaron C Miller - University of IowaAlan T Arakkal - University of IowaScott H Koeneman - University of IowaJoseph E Cavanaugh - University of IowaGeorge R Thompson - University of California, DavisJohn W Baddley - University of Maryland, BaltimorePhilip M Polgreen - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Journal of fungi (Basel), Vol.8(5), p.438
- DOI
- 10.3390/jof8050438
- PMID
- 35628693
- PMCID
- PMC9143509
- NLM abbreviation
- J Fungi (Basel)
- eISSN
- 2309-608X
- Publisher
- MDPI AG
- Grant note
- DOI: 10.13039/100000133, name: Agency for Healthcare Research and Quality, award: R01 HS027375
- Language
- English
- Date published
- 01/01/2022
- Academic Unit
- Statistics and Actuarial Science; Infectious Diseases; Epidemiology; Biostatistics; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9984259335302771
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