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Demographic Differences and Disparities in the Misdiagnosis of Interstitial Cystitis/Bladder Pain Syndrome in a National Cohort of VA Patients
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5 2022
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Source: Urology. 163:22-28
[PDF-692.77 KB]
Details:
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Alternative Title:Urology
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Personal Author:
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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.
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Source:
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Pubmed ID:34348123
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Pubmed Central ID:PMC10461430
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Document Type:
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Funding:
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Volume:163
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