Why is misdiagnosis more likely among some people with rare diseases than others? Insights from a population-based cross-sectional study in China

Abstract Background For patients with rare diseases (RD), misdiagnosis (or erroneous diagnosis) is one of the key issues that hinder RD patients’ accessibility to timely treatment. Yet, little is known about the main factors that are associated with RD patients’ misdiagnosis. The objective of this study is to analyze data from a national survey among 2040 RD patients from China to explore the association between misdiagnosis and various factors, including patients’ demographics, socio-economic status, medical history, and their accessibility to RD information. Results Three binary logistic regression analyses were performed to assess the relationships between misdiagnosis and level of rarity of the RDs (mild, moderate, and severe), demographics, health insurance levels, and accessibility to disease-related information by using the total sample, and the adult and non-adult sub-samples. We found that accessibility to RD information is the most critical factor influencing the patients’ chances of being misdiagnosed (odds ratio [OR] = 4.459, p < 0.001). In other words, the greater the difficulty in accessing the information on RD management, the higher the possibility of experiencing misdiagnosis. Such influences of information accessibility on misdiagnosis were repeatedly discovered when examining the adult (OR = 3.732, p < 0.001) and the non-adult (OR = 5.174, p < 0.001) sub-samples. The association between perceived economic status and misdiagnosis was only significant in the total sample. The only other factor significantly associated with misdiagnosis was disease multimorbidity: participants who reported no multimorbidity are less likely to experience misdiagnosis (OR = 0.42, p < 0.001). Conclusions Our study indicated that patients with RDs who have difficulty in accessing disease-related information are two to five times more likely to have experienced misdiagnosis. Even after adjusting for the patients’ age, gender, economic levels, and education levels, the impact of information accessibility was still significant. Our finding highlights the importance of access to information in reducing misdiagnosis among RD patients.

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Why is misdiagnosis more likely among some people with rare diseases than others? Insights from a population-based cross-sectional study in China

10.21203/rs.2.17761/v3 ◽

2020 ◽

Author(s):

Dong Dong ◽

Roger Yat-Nork Chung ◽

Rufina H.W. Chan ◽

Shiwei Gong ◽

Richard Huan Xu

Keyword(s):

Rare Diseases ◽

Economic Status ◽

Critical Factor ◽

Total Sample ◽

Population Based ◽

Cross Sectional Study ◽

Cross Sectional ◽

Related Information ◽

Information Accessibility ◽

The Impact

Abstract BackgroundFor patients with rare diseases (RD), misdiagnosis (or erroneous diagnosis) is one of the key issues that hinder RD patients’ accessibility to timely treatment. Yet, little is known about the main factors that are associated with RD patients’ misdiagnosis. The objective of this study is to analyze data from a national survey among 2,040 RD patients from China to explore the association between misdiagnosis and various factors, including patients’ demographics, socio-economic status, medical history, and their accessibility to RD information.ResultsThree binary logistic regression analyses were performed to assess the relationships between misdiagnosis and level of rarity of the RDs (mild, moderate, and severe), demographics, health insurance levels, and accessibility to disease-related information by using the total sample, and the adult and non-adult sub-samples. We found that accessibility to RD information is the most critical factor influencing the patients’ chances of being misdiagnosed (odds ratio [OR] =4.459, p<0.001). In other words, the greater the difficulty in accessing the information on RD management, the higher the possibility of experiencing misdiagnosis.Such influences of information accessibility on misdiagnosis were repeatedly discovered when examining the adult (OR=3.732, p<0.001) and the non-adult (OR=5.174, p<0.001) sub-samples. The association between perceived economic status and misdiagnosis was only significant in the total sample. The only other factor significantly associated with misdiagnosis was disease multimorbidity: participants who reported no multimorbidity are less likely to experience misdiagnosis (OR=0.42, p<0.001).ConclusionsOur study indicated that patients with RDs who have difficulty in accessing disease-related information are two to five times more likely to have experienced misdiagnosis. Even after adjusting for the patients’ age, gender, economic levels, and education levels, the impact of information accessibility was still significant. Our finding highlights the importance of access to information in reducing misdiagnosis among RD patients.

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Why is misdiagnosis more likely among some people with rare diseases than others? Insights from a population-based cross-sectional study in China

10.21203/rs.2.17761/v1 ◽

2019 ◽

Author(s):

Dong Dong ◽

Roger Yat-Nork Chung ◽

Rufina Chan ◽

Shiwei Gong ◽

Huan Xu

Keyword(s):

Rare Diseases ◽

Economic Status ◽

Critical Factor ◽

Total Sample ◽

Population Based ◽

Cross Sectional Study ◽

Cross Sectional ◽

Related Information ◽

Information Accessibility ◽

The Impact

Abstract Background For patients with rare diseases (RD), misdiagnosis has been regarded as one of the key issues that hinder RD patients’ accessibility to timely treatment. Yet, less is known about the main factors associated with RD patients’ misdiagnosis. The objective of this study is to use the data from a national survey among 2,040 RD patients from China to explore the association between misdiagnosis and other factors, including patients’ demographics, socio-economic characteristics, medical history, and their accessibility to RD information.Results Three binary logistic regression analyses were performed to estimate the relationships between misdiagnosis and level of rarity of the RDs (mild, moderate and severe), demographics, health insurance levels and accessibility to disease-related information by using the total sample, and the adult and minor sub-samples.It is found that accessibility to RD information is the most critical factor influencing the patients’ chances of being misdiagnosed. In other words, the greater the difficulty in accessing information on RD management, the higher the possibility of experiencing misdiagnosis.Such influences from information accessibility to misdiagnosis were repeatedly discovered when exploring the adult and the minor sub-samples. The association between perceived economic status and misdiagnosis only occurs in the total sample. The only other factor significantly associated misdiagnosis was disease complication: participants who reported no complications are less likely to experience misdiagnosis.Conclusions Our study indicated that patients with RDs who have difficulty in accessing disease-related information have nearly two to five times higher chances of being misdiagnosed. Even after considering the patients’ age, gender, economic levels and education levels, the impact of information accessibility still stands out. Our finding highlights the fact that accessibility to information is the key to reducing misdiagnosis among RD patients.

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Why is misdiagnosis more likely among some people with rare diseases than others? Insights from a population-based cross-sectional study in China

10.21203/rs.2.17761/v2 ◽

2020 ◽

Author(s):

Dong Dong ◽

Roger Yat-Nork Chung ◽

Rufina H.W. Chan ◽

Shiwei Gong ◽

Richard Huan Xu

Keyword(s):

Rare Diseases ◽

Economic Status ◽

Critical Factor ◽

Total Sample ◽

Population Based ◽

Cross Sectional Study ◽

Cross Sectional ◽

Related Information ◽

Information Accessibility ◽

The Impact

Abstract Background For patients with rare diseases (RD), misdiagnosis (or erroneous diagnosis) is one of the key issues that hinder RD patients’ accessibility to timely treatment. Yet, little is known about the main factors that are associated with RD patients’ misdiagnosis. The objective of this study is to analyze data from a national survey among 2,040 RD patients from China to explore the association between misdiagnosis and various factors, including patients’ demographics, socio-economic status, medical history, and their accessibility to RD information. Results Three binary logistic regression analyses were performed to assess the relationships between misdiagnosis and level of rarity of the RDs (mild, moderate, and severe), demographics, health insurance levels, and accessibility to disease-related information by using the total sample, and the adult and non-adult sub-samples. We found that accessibility to RD information is the most critical factor influencing the patients’ chances of being misdiagnosed (odds ratio [OR] =4.459, p<0.001). In other words, the greater the difficulty in accessing the information on RD management, the higher the possibility of experiencing misdiagnosis. Such influences of information accessibility on misdiagnosis were repeatedly discovered when examining the adult (OR=3.732, p<0.001) and the non-adult (OR=5.174, p<0.001) sub-samples. The association between perceived economic status and misdiagnosis was only significant in the total sample. The only other factor significantly associated with misdiagnosis was disease multimorbidity: participants who reported no multimorbidity are less likely to experience misdiagnosis (OR=0.42, p<0.001).Conclusions Our study indicated that patients with RDs who have difficulty in accessing disease-related information are two to five times more likely to have experienced misdiagnosis. Even after adjusting for the patients’ age, gender, economic levels, and education levels, the impact of information accessibility was still significant. Our finding highlights the importance of access to information in reducing misdiagnosis among RD patients.

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Socio-Economic Status and Prevalence of Self-Reported Osteoporosis in Tehran: Results from a Large Population-Based Cross-Sectional Study (Urban HEART-2)

Journal of Urban Health ◽

10.1007/s11524-018-0246-6 ◽

2018 ◽

Vol 95 (5) ◽

pp. 682-690 ◽

Cited By ~ 2

Author(s):

M. Asadi-Lari ◽

Y. Salimi ◽

M. R. Vaez-Mahdavi ◽

S. Faghihzadeh ◽

A. A. Haeri Mehrizi ◽

...

Keyword(s):

Economic Status ◽

Large Population ◽

Population Based ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Socio Economic Status

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Mediating Effect of Chronic Illnesses in the Relationship Between Psychological Distress and COVID-19 Vaccine Acceptance

Asia Pacific Journal of Public Health ◽

10.1177/10105395211047868 ◽

2021 ◽

pp. 101053952110478

Author(s):

Won Sun Chen ◽

Ching Sin Siau ◽

Suzanna Awang Bono ◽

Wah Yun Low

Keyword(s):

Psychological Distress ◽

Psychological Health ◽

Economic Status ◽

Cross Sectional Study ◽

Chronic Illnesses ◽

Mediating Effect ◽

Cross Sectional ◽

Vaccine Acceptance ◽

The Impact ◽

The Relationship

The impact of the COVID-19 pandemic on mental health is an emerging problem globally. This study aimed to examine the mediating effect of chronic illnesses in the relationship between psychological health and the acceptance of the COVID-19 vaccine, prior to the national vaccine rollout in Malaysia. An online cross-sectional study was conducted in Malaysia between December 10, 2020, and February 9, 2021. In addition to the descriptive analyses, a mediation analysis was performed to examine the mediating effect of chronic illnesses in the relationship between psychological distress and the willingness to accept the vaccine. A total of 1738 participants completed the survey. The psychological distress levels were found to be significantly different across demographic factors such as age, gender, and social economic status. This study demonstrated a partial mediating effect of chronic illnesses in the relationship between psychological distress and vaccine acceptance.

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Relationship between sleep duration and hypertension in northeast China: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2018-023916 ◽

2019 ◽

Vol 9 (1) ◽

pp. e023916 ◽

Cited By ~ 5

Author(s):

Meng Li ◽

Shoumeng Yan ◽

Shan Jiang ◽

Xiaoyu Ma ◽

Tianyu Gao ◽

...

Keyword(s):

Blood Pressure ◽

Sleep Duration ◽

Northeast China ◽

Total Sample ◽

Population Based ◽

Cross Sectional Study ◽

Cluster Sampling ◽

Sectional Study ◽

Short Sleep Duration ◽

Cross Sectional

ObjectivesPrevious studies have reported that sleep duration might increase the risk of hypertension. However, the results have been conflicting. We investigated whether sleep duration is independently associated with hypertension. We aimed to assess the relationship between sleep duration and hypertension in a population-based cross-sectional study.MethodsIn this study we used multistage stratified cluster sampling. A total of 19 407 adults aged 18–79 years were enrolled in the study. The participants were divided into three groups (<7 hours/day, 7–8 hours/day and >8 hours/day) according to self-reported sleep duration. Hypertension was defined as systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or the use of anti-hypertensive medications. Univariate and multivariate logistic regressions were performed to determine the association between hypertension and sleep duration adjusted for sociodemographic, body mass index, and lifestyle covariates.ResultsThe overall prevalence of hypertension was 32.6%. Among participants aged 18–44 years, individuals sleeping less than 7 hours per day had a higher risk of hypertension (OR=1.24, 95% CI: 1.05 to 1.46), compared with those who slept 7–8 hours per day. There were no significant associations between sleep duration and hypertension in the total sample, among middle-aged adults (45–59 years) or older adults (60–79 years).ConclusionsOur study demonstrates that short sleep duration was significantly associated with hypertension among people aged 18–44 years in northeast China.

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Which body mass index is best associated with risk of diabetes mellitus and hypertension in a Japanese-Brazilian population?

Cadernos de Saúde Pública ◽

10.1590/s0102-311x2007000200005 ◽

2007 ◽

Vol 23 (2) ◽

pp. 297-304 ◽

Cited By ~ 2

Author(s):

Rosana Farah Simony ◽

Suely Godoy Agostinho Gimeno ◽

Sandra Roberta Gouveia Ferreira ◽

Laércio Joel Franco

Keyword(s):

Diabetes Mellitus ◽

Body Mass Index ◽

Body Mass ◽

Sensitivity And Specificity ◽

Population Based ◽

Cross Sectional Study ◽

Odds Ratios ◽

Cross Sectional ◽

Japanese Brazilians ◽

The Impact

The objective of this study was to evaluate the impact of different body mass index (BMI) ranges associated with the risk of diabetes and hypertension in Japanese-Brazilians. This cross-sectional study was based on data from 1,330 Japanese-Brazilians > 30 years of age who participated in a population-based survey on the prevalence of diabetes mellitus and associated diseases. Glucose tolerance status was classified according to WHO criteria and blood pressure levels according to the VI-JNC. Odds ratios for diabetes and hypertension were calculated for different BMI ranges; for different BMIs, sensitivity and specificity for percentiles 25, 50, 75, 90 and 95 were obtained. Increased odds ratios for diabetes mellitus and hypertension were observed with BMI values > 25kg/m². The 50th percentile corresponded to the highest sensitivity and specificity for the identification of risk for both diseases. Our results suggest that BMI values proposed by WHO should also be useful for this group of Japanese descendants in the assessment of risk for DM and hypertension.

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Self-reported physical activity in European adolescents: results from the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study

Public Health Nutrition ◽

10.1017/s1368980010000558 ◽

2010 ◽

Vol 14 (2) ◽

pp. 246-254 ◽

Cited By ~ 30

Author(s):

Katrien De Cocker ◽

Charlene Ottevaere ◽

Michael Sjöström ◽

Luis A Moreno ◽

Julia Wärnberg ◽

...

Keyword(s):

Physical Activity ◽

Weight Status ◽

Leisure Time ◽

Healthy Lifestyle ◽

Economic Status ◽

Age Groups ◽

Total Sample ◽

Cross Sectional Study ◽

Cross Sectional ◽

Home Based

AbstractObjectiveTo describe self-reported physical activity (PA) patterns in the various domains (school, home, transport, leisure time) and intensity categories (walking, moderate PA, vigorous PA) in European adolescents. Furthermore, self-reported PA patterns were evaluated in relation to gender, age category, weight status category and socio-economic status (SES).DesignCross-sectional study.SettingTen European cities.SubjectsIn total, 3051 adolescents (47·6 % boys, mean age 14·8 (sd1·2) years) completed an adolescent-adapted version of the validated International Physical Activity Questionnaire.ResultsThe total sample reported most PA during leisure time (485 min/week) and least PA at home (140 min/week). Boys reported significantly more school-based PA (P< 0·001), leisure-time PA (P= 0·003), vigorous PA (P< 0·001) and total PA (P= 0·002) than girls, while girls reported more home-based PA (P< 0·001) and walking (P= 0·002) than boys. Self-reported PA at school (P< 0·001), moderate PA (P< 0·001), vigorous PA (P< 0·001) and total PA (P< 0·001) were significantly higher in younger age groups than in older groups. Groups based on weight status differed significantly only in leisure-time PA (P= 0·004) and total PA (P= 0·003), while groups based on SES differed in all PA domains and intensities except transport-related PA and total PA.ConclusionsThe total sample of adolescents reported different scores for the different PA domains and intensity categories. Furthermore, patterns were different according the adolescents’ gender, age, weight status and SES.

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Determinants of Health-Related Quality of Life in Rural Elderly People of the West of Iran: A Population-Based, Cross-Sectional Study

International journal of epidemiologic research ◽

10.15171/ijer.2019.01 ◽

2019 ◽

Vol 6 (1) ◽

pp. 1-7

Author(s):

Marjan Hosseinpour ◽

Mohammad Esmaeilpour Aghdam ◽

Masumeh Piri ◽

Farzad Maleki

Keyword(s):

Quality Of Life ◽

Economic Status ◽

Population Based ◽

Cross Sectional Study ◽

Health Related Quality ◽

Sectional Study ◽

Cross Sectional ◽

Related Quality ◽

Health Related

Background and aims: World’s older population is growing, and attention is being directed to the improvement of their health-related quality of life (HRQoL). This article was conducted to investigate the HRQoL and associated factors in rural elderly residents in west of Iran. Methods: By using the multistage sampling method, 346 elders from rural areas of Shahindezh were enrolled in this population-based, cross-sectional study conducted in 2014. To assess the HRQoL of the elderly people, the Leiden-Padua (LEIPAD) questionnaire was used. The economic status was classified into 3 categories (good, moderate, and low) using the principal component analysis. Descriptive statistics, independent t test, ANOVA, and Spearman correlation coefficient were used to analyze data. Multivariate linear regression was performed to determine predictive factors. Results: The mean values and confidence intervals of total core scale and total moderator scale were 38.6 (36.7-40.6) and 31.2 (29.6-32.6), respectively. Univariate analysis showed age, marital status, economic status, occupation, income source, and ethnicity were associated with HRQoL (P<0.05). Multivariate analysis showed the married, the illiterate, widows/widowers and the divorced, people with low economic status, and the self-employed had low HRQoL with respect to total scale and total core scale models (P<0.05). Conclusion: HRQoL varies according to socioeconomic factors. Its determinants should be addressed in social and health policies designed to improve the health of older people, especially the most vulnerable groups.

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Sex ratios at birth in Australia according to mother’s country of birth: A national study of all 5 614 847 reported live births 1997–2016

PLoS ONE ◽

10.1371/journal.pone.0251588 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0251588

Author(s):

Kristina Edvardsson ◽

Mary-Ann Davey ◽

Rhonda Powell ◽

Anna Axmon

Keyword(s):

Total Sample ◽

Population Based ◽

Cross Sectional Study ◽

High Income ◽

Son Preference ◽

National Study ◽

Country Of Birth ◽

Cross Sectional ◽

Live Births ◽

Promote Gender Equality

Objectives Son preference and sex selective practices have resulted in a deficit of girls in several countries, primarily across Asia. Emerging evidence indicates that son preference survives migration to Western high-income countries. The objective of this study was to assess male-to-female (M/F) ratios at birth per mother’s country of birth in Australia 1997–2016, in total and by parity, and by states/territories and over time. Methods Data for this national population-based cross-sectional study were obtained from the National Perinatal Data Collection (NPDC) and included all live births in Australia 1997–2016 (N = 5 614 847). M/F ratios with 95% Confidence Intervals were estimated. Results The M/F ratio for births to Australian-born mothers was within the expected range (1.03–1.07) regardless of parity and time period. M/F ratios were elevated above the expected range for births to mothers born in China in the total sample (M/F ratio 1.084, 95% confidence interval 1.071–1.097) and at parity 2 (1.175, 1.120–1.231), and for births to mothers born in India at parity 2 (1.146, 1.090–1.204). Parity 2 births were the most consistently male-biased across time. Across states, elevated M/F ratios were identified for both groups in New South Wales (China parity 2: 1.182, 1.108–1.260; India parity 2: 1.182, 1.088–1.285), for births to Chinese-born mothers in Victoria (total births: 1.097, 1.072–1.123; parity 1: 1.115, 1.072–1.159) and Australian Capital Territory (total births: 1.189, 1.085–1.302) and births to Indian-born mothers Western Australia (parity 2: 1.307, 1.122–1.523). Conclusions Son preference persists in some immigrant communities after migration to Australia. The consistent pattern of elevated M/F ratios across the larger states indicates that sex imbalances at birth are largely independent of restrictiveness of local abortion laws. Drivers and consequences of son preference in Western high-income settings should be explored to further promote gender equality, and to strengthen support for women who may be vulnerable to reproductive coercion.

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