Understanding How the Diagnostic Delay of Spondyloarthritis Differs Between Women and Men: A Systematic Review and Metaanalysis

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Campo DCValorIdioma
dc.contributorSalud Públicaes_ES
dc.contributor.authorJovaní, Vega-
dc.contributor.authorBlasco-Blasco, Mar-
dc.contributor.authorRuiz-Cantero, María Teresa-
dc.contributor.authorPascual, Eliseo-
dc.contributor.otherUniversidad de Alicante. Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Cienciaes_ES
dc.identifier.citationThe Journal of Rheumatology. 2017, 44(2): 174-183. doi:10.3899/jrheum.160825es_ES
dc.identifier.issn0315-162X (Print)-
dc.identifier.issn1499-2752 (Online)-
dc.description.abstractObjective. To identify empirical evidence of diagnostic delay in spondyloarthritis (SpA), determine whether sex-related differences persist, and conduct an analysis from that perspective of the possible causes, including the influence of quality research, in this group of inflammatory rheumatic diseases. Methods. A systematic review was done of delay in diagnosis of SpA in MEDLINE and EMBASE and other sources. Study quality was determined in line with the Strengthening The Reporting of OBservational studies in Epidemiology (STROBE) statement. A metaanalysis of 13 papers reporting sex-disaggregated data was performed to evaluate sex-related differences in diagnostic delay. The global effect of diagnostic delay by sex was calculated using means difference (D) through a fixed effects model. Results. The review included 23,883 patients (32.3% women) from 42 papers. No significant differences between the sexes were detected for symptoms at disease onset or during evolution. However, the mean for delay in diagnosis of SpA showed sex-related differences, being 8.8 years (7.4–10.1) for women and 6.5 (5.6–7.4) for men (p = 0.01). Only 40% of papers had high quality. A metaanalysis included 12,073 participants (31.2% women). The mean global effect was D = 0.6 years (0.31–0.89), indicating that men were diagnosed 0.6 year (7 months) before women. Conclusion. Delay in diagnosis of SpA persists, and is longer in women than in men. There are no significant sex-related differences in symptoms that could explain sex-related differences in diagnostic delay. Methodological and possible publication bias could result in sex-biased medical practice.es_ES
dc.description.sponsorshipSupported by FEDER-Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación, Spain (grant PI11/00865).es_ES
dc.publisherThe Journal of Rheumatology Publishing Company Limitedes_ES
dc.rights© 2017 by The Journal of Rheumatology Publishing Company Limitedes_ES
dc.subjectSex differenceses_ES
dc.subjectSex biases_ES
dc.subjectDiagnostic delayes_ES
dc.subject.otherMedicina Preventiva y Salud Públicaes_ES
dc.titleUnderstanding How the Diagnostic Delay of Spondyloarthritis Differs Between Women and Men: A Systematic Review and Metaanalysises_ES
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