Diagnostic journeys: characterization of patients and diagnostic outcomes from an academic second opinion clinic.
diagnosis
diagnostic journey
medical mystery
second opinion
undiagnosed
Journal
Diagnosis (Berlin, Germany)
ISSN: 2194-802X
Titre abrégé: Diagnosis (Berl)
Pays: Germany
ID NLM: 101654734
Informations de publication
Date de publication:
01 08 2022
01 08 2022
Historique:
received:
09
03
2022
accepted:
19
04
2022
pubmed:
21
5
2022
medline:
1
9
2022
entrez:
20
5
2022
Statut:
epublish
Résumé
Diagnostic programs and second opinion clinics have grown and evolved in the recent years to help patients with rare, puzzling, and complex conditions who often suffer prolonged diagnostic journeys, but there is a paucity of literature on the clinical characteristics of these patients and the efficacy of these diagnostic programs. This study aims to characterize the diagnostic journey, case features, and diagnostic outcomes of patients referred to a team-based second opinion clinic at Stanford. Retrospective chart review was performed for 237 patients evaluated for diagnostic second opinion in the Stanford Consultative Medicine Clinic over a 5 year period. Descriptive case features and diagnostic outcomes were assessed, and correlation between the two was analyzed. Sixty-three percent of our patients were women. 49% of patients had a potential precipitating event within about a month prior to the start of their illness, such as medication change, infection, or medical procedure. A single clear diagnosis was determined in 33% of cases, whereas the remaining cases were assessed to have multifactorial contributors/diagnoses (20%) or remained unclear despite extensive evaluation (47%). Shorter duration of illness, fewer prior specialties seen, and single chief symptom were associated with higher likelihood of achieving a single clear diagnosis. A single-site academic consultative service can offer additional diagnostic insights for about half of all patients evaluated for puzzling conditions. Better understanding of the clinical patterns and patient experiences gained from this study helps inform strategies to shorten their diagnostic odysseys.
Identifiants
pubmed: 35596123
pii: dx-2022-0029
doi: 10.1515/dx-2022-0029
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
340-347Informations de copyright
© 2022 Walter de Gruyter GmbH, Berlin/Boston.
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