Patient-reported symptoms and diagnostic journey in Multiple Myeloma.
Patient-reported symptoms and diagnostic journey in Multiple Myeloma.
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DOI：
10.3389/fonc.2023.1282569
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发表时间：
2023
影响因子：
4.7
通讯作者：
中科院分区：
文献类型：
--
作者：
迟发的多发性骨髓瘤（MM）增加了并发症的风险，包括终末器官损伤。本研究旨在：1)详细描述MM患者的诊断过程，包括症状、初始诊断和见过的医护人员；2)建立从症状出现到MM诊断的中位时间；3)在12周内检查与MM及时诊断相关的因素。来自罕见和未确诊疾病队列研究（RUDY）的300名自我报告MM的成年人进行了分析。RUDY研究是一个基于网络的平台，参与者提供动态同意和自我报告他们的MM诊断和诊断过程的信息。这包括最初潜在首次症状的估计日期、这些症状的描述、他们咨询的医疗保健专业人员以及在MM诊断之前接受的其他诊断。描述性统计、组合分析和逻辑回归分析用于描述和检查MM个体的诊断过程。总体而言，52%的参与者在MM诊断前报告了其他诊断，其中最常见的是肌肉骨骼疾病（47.8%），如骨质疏松症、肋软骨炎或肌肉劳损。最常见的最初报告症状是背部疼痛/椎体骨折（47%），其次是胸部/肩部疼痛，包括肋骨疼痛和骨折（20%），以及疲劳/疲倦（19.7%）。40%的参与者被诊断为直接从初级保健转诊到血液学，没有看到其他医疗保健专业人员，而60%的参与者在诊断前咨询了其他专家。从症状出现到MM诊断的中位时间为4个月（IQR 2-10个月，范围0-172）。就诊于联合医疗保健专业人员，如物理治疗师、脊椎指压治疗师或整骨治疗师（or = 0.25, 95% CI [0.12, 0.47], p <0.001）、出现感染症状（or = 0.32, 95% CI [0.13, 0.76], p = 0.013）、胸部或肩部疼痛（or = 0.45, 95% CI [0.23, 0.86], p = 0.020）与12周内被诊断为MM的可能性较低相关。年龄越大（OR = 1.04, 95% CI [1.02, 1.07], p = 0.001）与12周内更高的诊断可能性相关。为专职医疗人员开发资源可以提高对MM的早期认识。
Late presentation of multiple myeloma (MM) heightens the risk of complication risks, including end-organ damage. This study aimed to: 1) detail the diagnostic journey of MM patients, encompassing symptoms, initial diagnoses, and healthcare professionals met; 2) establish the median duration from symptom onset to MM diagnosis; and 3) examine factors linked to timely MM diagnosis within 12 weeks. A total of 300 adults self-reporting MM were analysed from the Rare and Undiagnosed Diseases cohort Study (RUDY). The RUDY study is a web-based platform, where participants provide dynamic consent and self-report their MM diagnosis and information about their diagnostic journey. This includes the estimated date of initial potential first symptoms, descriptions of these symptoms, the healthcare professionals they consulted, and other diagnoses received before the MM diagnosis. Descriptive statistics, combinatorial analyses and logistic regression analyses were used to describe and examine the diagnostic journey of individuals with MM. Overall, 52% of the participants reported other diagnoses before MM diagnosis, with musculoskeletal disorders (47.8%), such as osteoporosis, costochondritis, or muscle strains, being the most common. The most prevalent initial reported symptom was back pain/vertebral fractures (47%), followed by chest/shoulder pain, including rib pain and fractures (20%), and fatigue/tiredness (19.7%). 40% of participants were diagnosed by direct referral from primary care to haematology without seeing other healthcare professionals whilst 60% consulted additional specialists before diagnosis. The median time from symptom onset to MM diagnosis was 4 months (IQR 2-10 months, range 0-172). Seeing an Allied Healthcare Professional such as a physiotherapist, chiropractor or an osteopath (OR = 0.25, 95% CI [0.12, 0.47], p <0.001), experiencing infection symptoms (OR = 0.32, 95% CI [0.13, 0.76], p = 0.013), and having chest or shoulder pain (OR = 0.45, 95% CI [0.23, 0.86], p = 0.020) were associated with a lower likelihood of being diagnosed with MM within 12 weeks. Older age (OR = 1.04, 95% CI [1.02, 1.07], p = 0.001) was associated with a higher likelihood of diagnosis within 12 weeks. Developing resources for allied health professionals may improve early recognition of MM.
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影响因子：
5.4
作者：
ANDERSEN, BL;CACIOPPO, JT;ROBERTS, DC
通讯作者：
ROBERTS, DC
DOI：
10.3122/jabfm.2016.06.150393
发表时间：
2016-01-01
影响因子：
2.9
作者：
Goldschmidt, Neta;Zamir, Leora;Paltiel, Ora
通讯作者：
Paltiel, Ora
影响因子：
3.7
作者：
Javaid, M. K.;Forestier-Zhang, L.;Kaye, J.
通讯作者：
Kaye, J.
影响因子：
8.9
作者：
Kyle, RA;Gertz, MA;Greipp, PR
通讯作者：
Greipp, PR
影响因子：
--
作者：
Howell, Debra A;Smith, Alexandra G;Roman, Eve
通讯作者：
Roman, Eve