Department for Health, University of Bath, Claverton Down, Bath, BA2 7AY, UK; Rheumatology Department, Royal National Hospital for Rheumatic Diseases & Brownsword Therapies Centre, Royal United Hospitals Bath NHS Foundation Trust, Combe Park, Bath, BA1 3NG, UK.
Rheumatology Department, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norfolk & Norwich, University Hospital, Colney Lane, Norwich NR4 7UY, UK.
Best Pract Res Clin Rheumatol. 2023 Sep;37(3):101870. doi: 10.1016/j.berh.2023.101870. Epub 2023 Aug 30.
Diagnostic delay in axial spondylarthritis (axSpA) remains an unacceptable worldwide problem; with evidence suggesting significant detrimental impact both clinically on the individual, and economically on society. There is therefore, a need for global action across various healthcare professions that come into contact with patients living, and suffering, with undiagnosed axSpA. Recent estimates of the median diagnostic delay suggest that globally, individuals with axSpA wait between 2 and 6 years for a diagnosis - revealing a clear benchmark for improvement. This timespan presents a window of opportunity for earlier diagnosis and intervention, which will likely improve patient outcomes. This review describes the current diagnostic delay as estimated across countries and over time, before presenting evidence from published strategies that may be implemented to improve this delay across primary and secondary care, including for specialties treating extra-musculoskeletal manifestations of axSpA (ophthalmology, gastroenterology, dermatology). Ongoing campaigns tackling delayed diagnosis in axSpA are also highlighted.
轴性脊柱关节炎（axSpA）的诊断延误仍然是一个不可接受的全球性问题；有证据表明，这对个体的临床和对社会的经济都有重大的不利影响。因此，需要在接触到未被诊断为 axSpA 的患者的各种医疗保健专业人员中采取全球行动。最近对中位数诊断延迟的估计表明，在全球范围内，axSpA 患者的诊断等待时间在 2 至 6 年之间-这揭示了一个明确的改进基准。这段时间为早期诊断和干预提供了机会，这可能会改善患者的预后。本综述描述了在呈现可用于改善初级和二级保健中这一延迟的已发表策略的证据之前，在各国和不同时间点估计的当前诊断延迟，包括治疗 axSpA 的肌肉骨骼外表现的专科（眼科、胃肠病学、皮肤病学）。还强调了正在进行的针对 axSpA 诊断延误的运动。
