Demographic Differences and Disparities in the Misdiagnosis of Interstitial Cystitis/Bladder Pain Syndrome in a National Cohort of VA Patients

Details

• Alternative Title:
  Urology
• Personal Author:
  Dallas, Kai B. ; Bresee, Catherine ; De Hoedt, Amanda ; Senechal, Justin F. ; Barbour, Kamil E. ; Kim, Jayoung ; Freedland, Stephen J. ; Anger, Jennifer T.
• Description:
  Objectives:
  
  To explore the association between misdiagnosis of IC/BPS and demographics. Interstitial cystitis/bladder pain syndrome (IC/BPS) is associated with significant diagnostic uncertainty, resulting in frequent misdiagnosis. There is little known about the potential impact of key demographic factors on IC/BPS prevalence and rates of misdiagnosis.
  
  Methods:
  
  All in the VA system between 1999–2016 were identified by ICD-9/10 codes for IC/BPS (595.1/N30.10) (n=9,503). ICD code accuracy for true IC/BPS was assessed by in-depth chart abstraction to determine actual IC/BPS presence by strict criteria. Associations were explored between rates of misdiagnosis and demographics.
  
  Results:
  
  IC/BPS criteria were met in only 651 (48.8%) of the 1,334 charts with an ICD code for IC/BPS reviewed in depth. There were no differences in the misdiagnosis rate by race (p=0.27) or by ethnicity (p=0.97), after adjusting for differences in age and gender. In IC/BPS-confirmed cases, female patients were diagnosed at a younger age than males (41.9 vs. 58.2 years, p<0.001). Black and Hispanic patients were diagnosed at a younger age compared to White (41.9 vs. 50.2 years, p<0.001) and non-Hispanic patients, respectively (41.1 vs. 49.1 years, p=0.002).
  
  Conclusion:
  
  There was a high rate of misdiagnosis of IC/BPS overall, with only 48.8% of patients with an ICD code for IC/BPS meeting diagnostic criteria. There were no significant associations between diagnostic accuracy and race/ethnicity. Black and Hispanic patients were more likely to receive a diagnosis of IC/BPS at a younger age, suggesting there may be differing natural histories of IC/BPS between racial/ethnic groups.
  
  
• Subjects:
  Article Cohort Studies Cystitis, Interstitial Demography Diagnostic Errors Female Humans Male
• Source:
  Urology. 163:22-28
• Pubmed ID:
  34348123
• Pubmed Central ID:
  PMC10461430
• Document Type:
  Journal Article
• Funding:
  U01 DP006079/DP/NCCDPHP CDC HHSUnited States/
• Volume:
  163
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:232525b3e7a744e51d466d8b000383f2ba0094a8fec9568f1eab54aed34bef44
• Download URL:
  https://stacks.cdc.gov/view/cdc/132426/cdc_132426_DS1.pdf
• File Type:
  [PDF - 692.77 KB ]