Murray Nicole, Truman Isabel, Milligan Gary, Modi Himanshu, Adlard Nicholas
Novartis Corporate Center (NOCC), Dublin, Ireland.
Adelphi Real World, Bollington, UK.
Dermatol Ther (Heidelb). 2024 Dec;14(12):3211-3227. doi: 10.1007/s13555-024-01291-0. Epub 2024 Nov 2.
Patients with hidradenitis suppurativa (HS) experience significantly delayed diagnoses of 7-10 years from symptom onset on average, but the reasons for this remain largely unknown. This study investigated drivers of diagnostic delay from the perspective of healthcare system equity.
A literature review was performed to identify published factors associated with delayed HS diagnosis to inform data analysis. Clinical and demographic data from the Adelphi HS Disease Specific Programme (DSP)™, a real-world cross-sectional survey of dermatologists and their consulting patients in France, Germany, Italy, Spain, the UK and the USA in 2020/2021, were used to model factors influencing delay to diagnosis from onset of symptoms and first consultation.
Factors influencing delay to HS diagnosis in the literature with the most available evidence were misdiagnosis, delay in specialist referral and patient embarrassment. Data analysis revealed that increasing age was associated with reduced diagnostic delay after symptom onset. Patients with HS who were White or in Germany were also more likely to receive a faster diagnosis. Smokers, patients with concomitant conditions, or a family history of HS were slower to be diagnosed. When time to diagnosis following first consultation was assessed, increasing age was associated with quicker diagnosis. Moreover, patients with a family history of HS were diagnosed quicker, whereas those with high body mass index, more concomitant conditions, in employment, managed by multiple physicians or European were more delayed.
On the basis of a thorough analysis of real-world data, multiple factors that potentially influenced the timely diagnosis of HS have been identified. For the first time, this study quantifies the relative impact of these modifiers, providing valuable insights into areas that require attention for faster diagnoses and improved disease outcomes.
化脓性汗腺炎（HS）患者从症状出现到确诊平均会有7至10年的显著延迟，但其中原因很大程度上仍不明确。本研究从医疗系统公平性的角度调查了诊断延迟的驱动因素。
进行文献综述以确定与HS诊断延迟相关的已发表因素，为数据分析提供参考。来自阿德尔菲HS疾病特定项目（DSP）™的临床和人口统计学数据被用于构建影响从症状出现到首次咨询的诊断延迟因素模型，该项目是2020/2021年在法国、德国、意大利、西班牙、英国和美国对皮肤科医生及其会诊患者进行的一项真实世界横断面调查。
文献中证据最多的影响HS诊断延迟的因素是误诊、专科转诊延迟和患者尴尬。数据分析显示，年龄增长与症状出现后诊断延迟的减少有关。白人或德国的HS患者也更有可能更快得到诊断。吸烟者、伴有其他疾病的患者或有HS家族史的患者诊断较慢。在评估首次咨询后的诊断时间时，年龄增长与更快诊断有关。此外，有HS家族史的患者诊断更快，而体重指数高、伴有更多其他疾病、在职、由多名医生管理或来自欧洲的患者诊断延迟更久。
在对真实世界数据进行全面分析的基础上，已确定了多个可能影响HS及时诊断的因素。本研究首次量化了这些影响因素的相对影响，为需要关注以实现更快诊断和改善疾病结局的领域提供了有价值的见解。
