title: Lag time between onset of symptoms and diagnosis in Venezuelan patients with rheumatoid arthritis.
abstract: A retrospective study in a hospital-based sample of Venezuelan patients with rheumatoid arthritis was made to estimate the lag time between onset of symptoms, diagnosis, and initiation of DMARD treatment. Medical records and in-person interview of patients to fill in a questionnaire collecting information on demographics and initiation of symptoms, first consultation with any physician, time of diagnosis, and initiation of first disease-modifying anti-rheumatic drug were reviewed. We performed descriptive statistics and multivariable linear regression analysis. Mean lag time between symptom onset and diagnosis of rheumatoid arthritis was 40.5 months (range 1-424). Mean lag time between onset of symptoms and first consultation with a physician and between first consultation and diagnosis was 16.3 and 23.9 months, respectively. Mean lag time between onset of symptoms and initiation of DMARD treatment was 56.9 months. A definitive diagnosis of rheumatoid arthritis was done by a rheumatologist in 251 patients (92.3%). First consultation with an orthopedist or a primary care physician, first consultation in a public versus a private health center, and diagnosis before 2000 were associated with longer lag time between onset of symptoms and diagnosis. Venezuelan patients with rheumatoid arthritis had a marked delay from disease onset to diagnosis and initiation of first DMARD. First consultation with an orthopedist and consultation in a public versus a private health center were the variables with the strongest effect on lag time to diagnosis and to initiation of first DMARD.
authors.affiliation: Division of Rheumatology, Centro Nacional de Enfermedades Reumáticas, Hospital Universitario de Caracas, Universidad Central de Venezuela, Caracas, Venezuela.
authors.forename: Elaudi
authors.initials: E
authors.lastname: Rodríguez-Polanco
authors.forename: Soham
authors.initials: S
authors.lastname: Al Snih
authors.forename: Yong-Fang
authors.initials: YF
authors.lastname: Kuo
authors.forename: Alberto
authors.initials: A
authors.lastname: Millán
authors.forename: Martín A
authors.initials: MA
authors.lastname: Rodríguez
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D003430:Cross-Sectional Studies; D057210:Delayed Diagnosis; D005260:Female; D016304:Hospitals, Private; D006779:Hospitals, Public; D006801:Humans; D016018:Least-Squares Analysis; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009985:Orthopedics; D011237:Predictive Value of Tests; D012017:Referral and Consultation; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014687:Venezuela / Q000453:epidemiology
chemical_list: D018501:Antirheumatic Agents