title: Diagnostic delay and complications for older adults with multiple myeloma.
abstract: Increased attention to timely diagnosis motivated us to study 5483 patients diagnosed with multiple myeloma using Medicare claims linked to tumor registries in the Surveillance, Epidemiology and End Results programme. We calculated the time between initial visits for anemia or back pain and for myeloma diagnosis, and used logistic regression to predict the likelihood of diagnostic delay, and also the likelihood of renal or skeletal complications. The median time between sign or symptom and myeloma diagnosis was 99 days. Patients with anemia, back pain and comorbidities were more likely to experience diagnostic delay (OR 1.6, 95% CI 1.3-2.0). Diagnosis while hospitalised (OR 2.5, 95% CI 2.2-2.9) and chemotherapy treatment within 6 months of diagnosis (OR 1.4, 95% CI 1.2-1.6) significantly predicted complications; diagnostic delay did not (OR 0.9, 95% CI 0.8-1.1). Our data suggest that complications are more strongly associated with health status and myeloma severity than with diagnostic delays.
authors.affiliation: School of Nursing, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Friese
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Abel
authors.forename: Lysa S
authors.initials: LS
authors.lastname: Magazu
authors.forename: Bridget A
authors.initials: BA
authors.lastname: Neville
authors.forename: Lisa C
authors.initials: LC
authors.lastname: Richardson
authors.forename: Craig C
authors.initials: CC
authors.lastname: Earle
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000209:etiology; D001416:Back Pain / Q000209:etiology; D001847:Bone Diseases / Q000209:etiology; D003625:Data Collection / Q000379:methods; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology; D016015:Logistic Models; D008297:Male; D009101:Multiple Myeloma / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology*; D011379:Prognosis; D013997:Time Factors