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Time to diagnosis in Cushing's syndrome: A meta-analysis based on 5367 patients


Rubinstein, German; Osswald, Andrea; Hoster, Eva; Beuschlein, Felix; et al (2020). Time to diagnosis in Cushing's syndrome: A meta-analysis based on 5367 patients. Journal of Clinical Endocrinology & Metabolism, 105(3):dgz136.

Abstract

CONTEXT
Signs and symptoms of Cushing's syndrome (CS) overlap with common diseases, such as the metabolic syndrome, obesity, osteoporosis, and depression. Therefore, it can take years to finally diagnose CS, though early diagnosis is important for prevention of complications.
OBJECTIVE
The aim of this study was to assess the time span between first symptoms and diagnosis of CS in different populations in order to identify factors associated with an early diagnosis.
DATA SOURCES
A systematic literature search via PubMed was performed to identify studies reporting on time to diagnosis in CS. In addition, unpublished data from patients of our tertiary care center and 4 other centers were included.
STUDY SELECTION
Clinical studies reporting on the time to diagnosis of CS were eligible. Corresponding authors were contacted to obtain additional information relevant to the research question.
DATA EXTRACTION
Data were extracted from the text of the retrieved articles and from additional information provided by authors contacted successfully. From initially 3326 screened studies 44 were included.
DATA SYNTHESIS
Mean time to diagnosis for patients with CS was 34 months (ectopic CS: 14 months; adrenal CS: 30 months; and pituitary CS: 38 months; p<0.001). No difference was found for gender, age (</≥ 18 years), and year of diagnosis (before/after 2000). Patients with pituitary CS had a longer time to diagnosis in Germany than elsewhere.
CONCLUSIONS
Time to diagnosis differs for subtypes of CS but not for gender and age. Time to diagnosis remains to be long and requires to be improved.

Abstract

CONTEXT
Signs and symptoms of Cushing's syndrome (CS) overlap with common diseases, such as the metabolic syndrome, obesity, osteoporosis, and depression. Therefore, it can take years to finally diagnose CS, though early diagnosis is important for prevention of complications.
OBJECTIVE
The aim of this study was to assess the time span between first symptoms and diagnosis of CS in different populations in order to identify factors associated with an early diagnosis.
DATA SOURCES
A systematic literature search via PubMed was performed to identify studies reporting on time to diagnosis in CS. In addition, unpublished data from patients of our tertiary care center and 4 other centers were included.
STUDY SELECTION
Clinical studies reporting on the time to diagnosis of CS were eligible. Corresponding authors were contacted to obtain additional information relevant to the research question.
DATA EXTRACTION
Data were extracted from the text of the retrieved articles and from additional information provided by authors contacted successfully. From initially 3326 screened studies 44 were included.
DATA SYNTHESIS
Mean time to diagnosis for patients with CS was 34 months (ectopic CS: 14 months; adrenal CS: 30 months; and pituitary CS: 38 months; p<0.001). No difference was found for gender, age (</≥ 18 years), and year of diagnosis (before/after 2000). Patients with pituitary CS had a longer time to diagnosis in Germany than elsewhere.
CONCLUSIONS
Time to diagnosis differs for subtypes of CS but not for gender and age. Time to diagnosis remains to be long and requires to be improved.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Endocrinology and Diabetology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:1 March 2020
Deposited On:17 Dec 2019 14:58
Last Modified:14 Feb 2020 16:27
Publisher:Oxford University Press
ISSN:0021-972X
OA Status:Closed
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1210/clinem/dgz136
PubMed ID:31665382

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