delayed diagnosis


Summary: Non-optimal interval of time between onset of symptoms, identification, and initiation of treatment.

Top Publications

  1. Aloulou S, El Mahfoudi A, El Omrani A, Khouchani M. [Factors related to late diagnosis of breast cancer: experience of CHU Mohammed VI Marrakech]. Pan Afr Med J. 2015;21:162 pubmed publisher
  2. van Diemen C, Kerstjens Frederikse W, Bergman K, de Koning T, Sikkema Raddatz B, van der Velde J, et al. Rapid Targeted Genomics in Critically Ill Newborns. Pediatrics. 2017;140: pubmed publisher
    ..It led to a fast diagnosis in 30% of critically ill children for whom the routine clinical workup was unsuccessful. ..
  3. Cromme S, Whitaker K, Winstanley K, Renzi C, Smith C, Wardle J. Worrying about wasting GP time as a barrier to help-seeking: a community-based, qualitative study. Br J Gen Pract. 2016;66:e474-82 pubmed publisher
    ..Friendly GP relationships, economic reasoning, and a focus on the GP's responsibilities as a medical professional reduce this worry. ..
  4. Segagni Lusignani L, Quaglio G, Atzori A, Nsuka J, Grainger R, Palma M, et al. Factors associated with patient and health care system delay in diagnosis for tuberculosis in the province of Luanda, Angola. BMC Infect Dis. 2013;13:168 pubmed publisher
    ..More efforts should be placed in ensuring the availability of essential resources and skills in all healthcare facilities other than the DOTS centres, especially those located in suburban areas. ..
  5. Johnston N, Sandys N. Delayed diagnosis of pulmonary tuberculosis in a 13-year-old Malawian boy. BMJ Case Rep. 2017;2017: pubmed publisher
    ..Early case detection is essential if childhood TB is to be controlled and eradicated.Delayed diagnosis of TB is associated with more advanced disease and worse treatment outcomes...
  6. Wang K, Austin S, Chen S, Sonne D, Gurushanthaiah D. Nasopharyngeal Carcinoma Diagnostic Challenge in a Nonendemic Setting: Our Experience with 101 Patients. Perm J. 2017;21: pubmed publisher
    ..An understanding of the risk factors, presenting symptoms, and limitations associated with these diagnostic tests is necessary to support earlier detection of this insidious cancer. ..
  7. Belkina T, Khojiev D, Tillyashaykhov M, Tigay Z, Kudenov M, Tebbens J, et al. Delay in the diagnosis and treatment of pulmonary tuberculosis in Uzbekistan: a cross-sectional study. BMC Infect Dis. 2014;14:624 pubmed publisher
    ..Efforts should be made to minimise irrational use of antibiotics and support interventions to restrict over-the-counter availability of antibiotics. ..
  8. Sarker M, Mohammad D, Paul S, Akter R, Islam S, Biswas G, et al. Lost in care pathway: a qualitative investigation on the health system delay of extra pulmonary tuberculosis patients in Bangladesh. BMC Health Serv Res. 2017;17:240 pubmed publisher
    ..The private and informal healthcare providers should receive appropriate training on the diagnosis of EPTB. Such training could effectively shorten the long and complex healthcare-seeking pathways of EPTB patients. ..
  9. Guo Y, Ding S, Guo H, Li S, Lu X, Chen Z, et al. Graft-versus-host-disease after kidney transplantation: A case report and literature review. Medicine (Baltimore). 2017;96:e7333 pubmed publisher
    ..MP bolus, IVIG, and decreased immunosuppression could be beneficial to the clinical outcome. Kidney recipients have a prognosis superior to recipients of organs bearing large numbers of lymphocytes. ..

More Information


  1. Mounce L, Price S, Valderas J, Hamilton W. Comorbid conditions delay diagnosis of colorectal cancer: a cohort study using electronic primary care records. Br J Cancer. 2017;116:1536-1543 pubmed publisher
    ..comorbid conditions were independently associated with longer diagnostic interval: a single competing demand delayed diagnosis by 10 days, and four or more by 32 days; and a single alternative explanation by 9 days...
  2. Inman A, Liu K, Ong K, Tiwari P, Vos P, White A, et al. Completeness of ultrasound reporting impacts time to biopsy for benign and malignant thyroid nodules. Am J Surg. 2017;213:931-935 pubmed publisher
    ..001, p = 0.007, and p < 0.001, respectively). Under-reporting of guideline-recommended US elements is associated with delayed cytological diagnosis and surgical treatment of thyroid nodules. ..
  3. van der Westhuizen H, Dramowski A. When students become patients: TB disease among medical undergraduates in Cape Town, South Africa. S Afr Med J. 2017;107:475-479 pubmed publisher
    ..Undergraduate medical students in Cape Town are at high risk of occupationally acquired TB, with an unmet need for comprehensive occupational health services and support. ..
  4. Thormann A, Sørensen P, Koch Henriksen N, Laursen B, Magyari M. Comorbidity in multiple sclerosis is associated with diagnostic delays and increased mortality. Neurology. 2017;89:1668-1675 pubmed publisher
    ..85 [1.34-6.06]; 0.007). An increased awareness of both the necessity of neurologic evaluation of new neurologic symptoms in persons with preexisting chronic disease and of optimum treatment of comorbidity in MS is critical. ..
  5. Schnetzke M, Porschke F, Hoppe K, Studier Fischer S, Gruetzner P, Guehring T. Outcome of Early and Late Diagnosed Essex-Lopresti Injury. J Bone Joint Surg Am. 2017;99:1043-1050 pubmed publisher
    ..Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. ..
  6. Ong P, Greulich S, Schumm J, Backes M, Kaufmann M, Bode Erdmann S, et al. Favorable course of pericardial angiosarcoma under paclitaxel followed by pazopanib treatment documented by cardiovascular magnetic resonance imaging. Circulation. 2012;126:e279-81 pubmed publisher
  7. Ilyasov B, Kartashev V, Bastrikov N, Morchon R, González Miguel J, Simon F. Delayed diagnosis of Dirofilariasis and complex ocular surgery, Russia. Emerg Infect Dis. 2013;19:326-8 pubmed
  8. Lee J, Lee C, Lee H. An Appropriate Lower Respiratory Tract Specimen Is Essential for Diagnosis of Middle East Respiratory Syndrome (MERS). J Korean Med Sci. 2015;30:1207-8 pubmed publisher
  9. Gueye M, Diouf G, Dia D, Boye A, Fall T, Dieme J, et al. [Costal metastasis revealing esophageal squamous cell carcinoma]. Pan Afr Med J. 2017;26:23 pubmed publisher
    Esophageal cancer is associated with poor prognosis. Its severity is linked to delayed diagnosis which is most often made once a cancer has metastasized, in Africa. Costal metastases are rare...
  10. Doshi P, Gopalan H, Sprague S, Pradhan C, Kulkarni S, Bhandari M. Incidence of infection following internal fixation of open and closed tibia fractures in India (INFINITI): a multi-centre observational cohort study. BMC Musculoskelet Disord. 2017;18:156 pubmed publisher
    ..NCT01691599 , September 17, 2012. ..
  11. Talbot C, Adam J, Paton R. Late presentation of developmental dysplasia of the hip : a 15-year observational study. Bone Joint J. 2017;99-B:1250-1255 pubmed publisher
    ..Cite this article: Bone Joint J 2017;99-B:1250-5. ..
  12. Nazareth R, Mason J. Takayasu arteritis: severe consequences of delayed diagnosis. QJM. 2011;104:797-800 pubmed publisher
  13. Winstone A, Stellitano L, Verity C. Niemann-Pick type C as a cause of progressive intellectual and neurological deterioration in childhood. Dev Med Child Neurol. 2017;59:965-972 pubmed publisher
    ..To describe the cases of Niemann-Pick type C (NP-C) disease in a United Kingdom epidemiological study of progressive intellectual and neurological deterioration in childhood...
  14. Guy R, Natoli L, Ward J, Causer L, Hengel B, Whiley D, et al. A randomised trial of point-of-care tests for chlamydia and gonorrhoea infections in remote Aboriginal communities: Test, Treat ANd GO- the "TTANGO" trial protocol. BMC Infect Dis. 2013;13:485 pubmed publisher
    ..Australian and New Zealand Clinical Trials Registry ACTRN12613000808741. ..
  15. Zhao Q, Liu F, Wu L, Ye M, Jia B, Ma X, et al. [Assessment of undiagnosed critical congenital heart disease before discharge from the maternity hospital]. Zhonghua Er Ke Za Zhi. 2017;55:260-266 pubmed publisher
    ..02% (544/766) were undiagnosed and the most common delayed diagnosis was SV (82.78%), interrupted aortic arch (81...
  16. Nasrallah N, Steiner H, Hasin Y. The challenge of chest pain in the emergency room: now and the future. Eur Heart J. 2011;32:656 pubmed
  17. Lyratzopoulos G, Wardle J, Rubin G. Rethinking diagnostic delay in cancer: how difficult is the diagnosis?. BMJ. 2014;349:g7400 pubmed publisher
  18. Tan K, Cullen K, Koumans E, Arguin P. Inadequate Diagnosis and Treatment of Malaria Among Travelers Returning from Africa During the Ebola Epidemic--United States, 2014-2015. MMWR Morb Mortal Wkly Rep. 2016;65:27-9 pubmed publisher
  19. Desserud K, Bukholm I, Søreide J. Compensation Claims for Sub-substandard Care of Patients with Gastroentero-pancreatic Neuroendocrine Tumors: A Nationwide Descriptive Study of Cases Between 2005-2016 in Norway. Anticancer Res. 2017;37:5667-5671 pubmed
    ..The clinical information and the medico-legal evaluation were reviewed...
  20. Chu Y, Wu S, Tsai Y, Liao Y, Chu H. Early Versus Late Canalicular Laceration Repair Outcomes. Am J Ophthalmol. 2017;182:155-159 pubmed publisher
    ..Delayed canalicular repair in unstable patients did not lead to poor results. An elective scheduling surgery, instead of an urgent repair, is feasible for an experienced surgeon. ..
  21. Tillmann T, Krishnadas R, Cavanagh J, Petrides K. Possible rheumatoid arthritis subtypes in terms of rheumatoid factor, depression, diagnostic delay and emotional expression: an exploratory case-control study. Arthritis Res Ther. 2013;15:R45 pubmed publisher
    ..RF- status, as well as diagnostic delay and emotional expression, may predict future risk of depression. Research on the causes of RA could benefit from a systems science approach. ..
  22. Martin S, Karra R, Mark D. Pheochromocytoma presenting as fever of unknown origin. Am J Med. 2011;124:e5-6 pubmed publisher
  23. Zaidi S, Manzoor N, Akhtar S. The challenge of head & neck squamous cell carcinoma control in Pakistan. J Pak Med Assoc. 2010;60:703-4 pubmed
  24. Peake M. Deprivation, distance and death in lung cancer. Thorax. 2015;70:108-9 pubmed publisher
  25. Bayne C, Villanueva J, Davis T, Pohl H, Rushton H. Factors Associated with Delayed Presentation and Misdiagnosis of Testicular Torsion: A Case-Control Study. J Pediatr. 2017;186:200-204 pubmed publisher
    ..Failure to perform a genitourinary examination or scrotal imaging was associated with misdiagnosis. ..
  26. Haase M, Haase Fielitz A. NGAL--from discovery to a new era of "acute renal disease" diagnosis?. Clin Biochem. 2011;44:499-500 pubmed publisher
  27. Broadis E, Banda M, Molyneux E, Borgstein E. Paediatric wandering spleens in Malawi. Malawi Med J. 2010;22:120-1 pubmed
  28. Raberahona M, Rakotoarivelo R, Razafinambinintsoa T, Andrianasolo R, Randria M. Clinical Features and Outcome in Adult Cases of Tuberculous Meningitis in Tertiary Care Hospital in Antananarivo, Madagascar. Biomed Res Int. 2017;2017:9316589 pubmed publisher
    ..i>Conclusion. Most of the patients experienced more than 3 weeks of diagnostic delay prior to admission. Mortality was high and occurred early after admission. Age and coma were identified as independent prognosis factors. ..
  29. Nelson D, Stern S, Elashoff D, Elashoff R, Thompson J, Mozzillo N, et al. Impact of Time Between Diagnosis and SLNB on Outcomes in Cutaneous Melanoma. J Am Coll Surg. 2017;225:302-311 pubmed publisher
    ..The MSLT-1 data confirm this result. Patients can be reassured that if the operation is performed 30 or more days after diagnosis, it will not cause harm. ..
  30. Freedman S, Rodean J, Hall M, Alpern E, Aronson P, Simon H, et al. Delayed Diagnoses in Children with Constipation: Multicenter Retrospective Cohort Study. J Pediatr. 2017;186:87-94.e16 pubmed publisher
    ..52). Among children diagnosed with constipation, abdominal radiograph performance is associated with an increased risk of a revisit with a clinically important alternate related diagnosis. ..
  31. Hassan N, Dasgupta B, Barraclough K. Giant cell arteritis. BMJ. 2011;342:d3019 pubmed publisher
  32. Tamaki Y, Nagamachi A, Inoue K, Takeuchi M, Sugiura K, Omichi Y, et al. Incidence and clinical features of sacral insufficiency fracture in the emergency department. Am J Emerg Med. 2017;35:1314-1316 pubmed publisher
    ..Findings at the second sacral segment on MRI targeting the lumbar spine may aid early diagnosis of this type of pelvic fracture. ..
  33. Machado F, Ferreira E, Sousa J, Silva C, Schippers P, Pereira A, et al. Quality Improvement Initiatives in Sepsis in an Emerging Country: Does the Institution's Main Source of Income Influence the Results? An Analysis of 21,103 Patients. Crit Care Med. 2017;45:1650-1659 pubmed publisher
    ..This quality improvement initiative in sepsis in an emerging country was associated with a reduction in mortality and with improved compliance with quality indicators. However, this reduction was sustained only in private institutions. ..
  34. Asres M, Gedefaw M, Kahsay A, Weldu Y. Patients' Delay in Seeking Health Care for Tuberculosis Diagnosis in East Gojjam Zone, Northwest Ethiopia. Am J Trop Med Hyg. 2017;96:1071-1075 pubmed publisher
    ..3%; 101/106) and traditional healers (84.6%; 11/13) were delayed. Therefore, for early seeking in modern health care, a combination of interventions is required to encourage TB patients. ..
  35. Morales López S, Parra Giraldo C, Ceballos Garzón A, Martínez H, Rodríguez G, Álvarez Moreno C, et al. Invasive Infections with Multidrug-Resistant Yeast Candida auris, Colombia. Emerg Infect Dis. 2017;23:162-164 pubmed publisher
    ..We report finding 17 cases of C. auris infection that were originally misclassified but correctly identified 27.5 days later on average. Patients with a delayed diagnosis of C. auris had a 30-day mortality rate of 35.2%.
  36. Lodi S, Dray Spira R, Touloumi G, Braun D, Teira R, D Arminio Monforte A, et al. Delayed HIV diagnosis and initiation of antiretroviral therapy: inequalities by educational level, COHERE in EuroCoord. AIDS. 2014;28:2297-306 pubmed publisher
  37. Leff M, Vrublevska J, Luse A, Rancāns E. Latvian family physicians' experience diagnosing depression in somatically presenting depression patients: A qualitative study. Eur J Gen Pract. 2017;23:91-97 pubmed publisher
  38. Miller M, Levy M. Chronic obstructive pulmonary disease: missed diagnosis versus misdiagnosis. BMJ. 2015;351:h3021 pubmed publisher
  39. Liu X, Yang L, Tang L, Chen L, Liu X, Fan D. DCTN1 gene analysis in Chinese patients with sporadic amyotrophic lateral sclerosis. PLoS ONE. 2017;12:e0182572 pubmed publisher
    ..Our results suggested that variants in DCTN1 are not common risk factors for Chinese sporadic ALS and that the frequency of variants of unknown significance in the cohort study was 0.39%. ..
  40. Elsa Rodríguez Angulo -, Marco Palma Solís -, Rita Zapata Vázquez -. [Causes of delays in obstetric complications care. What is necessary to address? ]. Ginecol Obstet Mex. 2014;82:647-58 pubmed
    ..Studies are needed to analyze the causes of delay in health services in order to be able to propose preventive models aimed at their reduction. ..
  41. Fanari Z, Abraham N, Hammami S, Doorey A. Aggressive Measures to Decrease Door to Balloon Time May Increase the Incidence of Unnecessary Cardiac Catheterization and Delay Appropriate Care. Del Med J. 2015;87:276-9 pubmed
    ..We report two cases where trying to achieve an aggressive DTB time may have led to unwarranted outcomes. ..
  42. Dyer K, Dumenci L, Siminoff L, Thomson M, Lafata J. The contribution of body mass index to appraisal delay in colorectal cancer diagnosis: a structural equation modelling study. Br J Cancer. 2017;116:1638-1642 pubmed publisher
    ..Model results support the hypothesis that increased BMI is significantly and directly associated with increased AD and key cognitive barriers relevant to care-seeking behaviour. ..
  43. McCombie S, Bangash H, Kuan M, Thyer I, Lee F, Hayne D. Delays in the diagnosis and initial treatment of bladder cancer in Western Australia. BJU Int. 2017;120 Suppl 3:28-34 pubmed publisher
    ..These concerning data warrant consideration of how delays can be reduced to improve outcomes for these patients. ..
  44. Santana C, Lopes A, de Paiva A, Benvenuti L. Case 1/2016--56-Year-Old Male with Atrial Septal Defect, Pulmonary Arterial Hypertension, Hospitalized Due to Eisenmenger Syndrome. Arq Bras Cardiol. 2016;106:250-8 pubmed publisher
  45. Ransome Y, Dean L, Crawford N, Metzger D, Blank M, Nunn A. How Do Social Capital and HIV/AIDS Outcomes Geographically Cluster and Which Sociocontextual Mechanisms Predict Differences Across Clusters?. J Acquir Immune Defic Syndr. 2017;76:13-22 pubmed publisher
    ..HIV prevention interventions should account for this phenomenon. Reducing geographic disparities will require interventions tailored to each continuum step and that address socioeconomic factors such as neighborhood median income. ..
  46. Mills K, Emery J, Cheung C, Hall N, Birt L, Walter F. A qualitative exploration of the use of calendar landmarking instruments in cancer symptom research. BMC Fam Pract. 2014;15:167 pubmed publisher
    ..The major challenge remains as to whether they actually improve accuracy of recall. ..
  47. Saunte D, Boer J, Stratigos A, Szepietowski J, Hamzavi I, Kim K, et al. Diagnostic delay in hidradenitis suppurativa is a global problem. Br J Dermatol. 2015;173:1546-9 pubmed publisher
  48. Wu X, Zhao X, Zhang B, Xuan F, Guo H, Ma F. A novel frameshift mutation of Chediak-Higashi syndrome and treatment in the accelerated phase. Braz J Med Biol Res. 2017;50:e5727 pubmed publisher
    ..He was diagnosed with CHS by gene sequencing, and had entered the accelerated phase. After 8 weeks of therapy, the boy had remission and was prepared for allogenic stem cell transplantation. ..
  49. Rhodus N, Kerr A, Patel K. Oral cancer: leukoplakia, premalignancy, and squamous cell carcinoma. Dent Clin North Am. 2014;58:315-40 pubmed publisher
  50. Round T, Steed L, Shankleman J, Bourke L, Risi L. Primary care delays in diagnosing cancer: what is causing them and what can we do about them?. J R Soc Med. 2013;106:437-40 pubmed publisher
  51. Lau L, Wee B, Wang S, Thian Y. Metastatic breast cancer to the rectum: A case report with emphasis on MRI features. Medicine (Baltimore). 2017;96:e6739 pubmed publisher
    ..The unique MRI features described in our case when present with a concordant history of lobular breast carcinoma should alert the radiologist to the possibility of this diagnosis which has important treatment implications. ..
  52. Di Chiacchio N, Tavares G, Tosti A, Di Chiacchio N, Di Santis E, Alvarenga L, et al. Onychomatricoma: epidemiological and clinical findings in a large series of 30 cases. Br J Dermatol. 2015;173:1305-7 pubmed publisher
  53. Haydar S, Spanier M, Weems P, Wood S, Strout T. Comparison of QSOFA score and SIRS criteria as screening mechanisms for emergency department sepsis. Am J Emerg Med. 2017;35:1730-1733 pubmed publisher
    ..As the time to meet qSOFA criteria was significantly longer than for SIRS, relying on qSOFA alone may delay initiation of evidence-based interventions known to improve sepsis-related outcomes. ..
  54. Jeon M, Kim W, Kwon H, Kim M, Park S, Oh H, et al. Clinical outcomes after delayed thyroid surgery in patients with papillary thyroid microcarcinoma. Eur J Endocrinol. 2017;177:25-31 pubmed publisher
    ..These findings support the notion that surgical treatment can be safely delayed in patients with PTMC under close monitoring. ..
  55. Bykerk V, Emery P. Delay in receiving rheumatology care leads to long-term harm. Arthritis Rheum. 2010;62:3519-21 pubmed publisher
  56. Buszewicz M, Chew Graham C. Improving the detection and management of anxiety disorders in primary care. Br J Gen Pract. 2011;61:489-90 pubmed publisher
  57. Tørring M, Murchie P, Hamilton W, Vedsted P, Esteva M, Lautrup M, et al. Evidence of advanced stage colorectal cancer with longer diagnostic intervals: a pooled analysis of seven primary care cohorts comprising 11?720 patients in five countries. Br J Cancer. 2017;117:888-897 pubmed publisher
    ..Furthermore, the study cannot define a specific 'safe' waiting time as the length of the primary care interval appears to have negative impact from day one. ..
  58. Brooke M, Victorino G. Repeat computed tomography is highly sensitive in determining need for delayed exploration in blunt abdominal trauma. J Surg Res. 2017;219:116-121 pubmed publisher
    ..We hypothesized that a repeat CT would accurately identify the need for an exploratory laparotomy in this patient population...
  59. Cavero T, Rabasco C, Molero A, Blázquez A, Hernández E, Martín M, et al. When should a nephrologist suspect a mitochondrial disease?. Nefrologia. 2015;35:6-17 pubmed publisher
    ..Specific treatments do not exist for the majority of mitochondrial diseases, but it is likely that the intense research that currently exists for these diseases will eventually produce effective treatment possibilities. ..
  60. Storz P. Targeting the alternative NF-?B pathway in pancreatic cancer: a new direction for therapy?. Expert Rev Anticancer Ther. 2013;13:501-4 pubmed publisher
  61. Gentry J, Rango J, Zhang J, Biedermann S. Latent Presentation of Decompression Sickness After Altitude Chamber Training in an Active Duty Flier. Aerosp Med Hum Perform. 2017;88:427-430 pubmed publisher
    ..Gentry J, Rango J, Zhang J, Biedermann S. Latent presentation of decompression sickness after altitude chamber training in an active duty flier. Aerosp Med Hum Perform. 2017; 88(4):427-430. ..
  62. Furlan A, Tublin M, Rees M, Nicholas D, Sperry J, Alarcon L. Delayed splenic vascular injury after nonoperative management of blunt splenic trauma. J Surg Res. 2017;211:87-94 pubmed publisher
    ..DSVI on follow-up CT scan imaging of patients managed nonoperatively after splenic injury is common and associated with splenic injury score assessed on admission CT scan. ..
  63. Bogale S, Diro E, Shiferaw A, Yenit M. Factors associated with the length of delay with tuberculosis diagnosis and treatment among adult tuberculosis patients attending at public health facilities in Gondar town, Northwest, Ethiopia. BMC Infect Dis. 2017;17:145 pubmed publisher
    ..Therefore, public awareness on the symptoms of tuberculosis and seeking health care early is essential. Moreover, early diagnosis and treatment, especially among the rural dwellers and the poor should be focused. ..
  64. Maheu Giroux M, Tanser F, Boily M, Pillay D, Joseph S, Barnighausen T. Determinants of time from HIV infection to linkage-to-care in rural KwaZulu-Natal, South Africa. AIDS. 2017;31:1017-1024 pubmed publisher
    ..Targeted interventions for men and young individuals have the largest potential to improve linkage rates. ..
  65. Mouhadi K, Boulahri T, Rouimi A. [Tuberculous meningoencephalitis revealed by psychiatric disorders: about a case]. Pan Afr Med J. 2017;27:206 pubmed publisher
    ..This delay is primarily due to a wide clinical polymorphism and, in particular, to misleading forms. We here report a rare clinical case of tuberculous meningitis in a patient in prodromal phase of psychosis. ..
  66. Daniels A, Ruttiman R, Eltorai A, DePasse J, Brea B, Palumbo M. Malpractice litigation following spine surgery. J Neurosurg Spine. 2017;27:470-475 pubmed publisher
  67. Hamilton W, Coleman M, Rubin G. Colorectal cancer. BMJ. 2013;346:f3172 pubmed publisher
  68. Faiz K, Sundseth A, Thommessen B, Rønning O. Prehospital path in acute stroke. Tidsskr Nor Laegeforen. 2017;137:798-802 pubmed publisher
    ..The findings from this study may indicate a need for specific training of this group of health care professionals in the prompt handling of patients with possible stroke. ..
  69. Alam M, Winch P, Saxton R, Nizame F, Yeasmin F, Norman G, et al. Behaviour change intervention to improve shared toilet maintenance and cleanliness in urban slums of Dhaka: a cluster-randomised controlled trial. Trop Med Int Health. 2017;22:1000-1011 pubmed publisher
    ..Future research might explore how residents can self-finance toilet maintenance, or employ mass media to reduce per-capita costs of behaviour change. ..
  70. Wandtke B, Gallagher S. Reducing Delay in Diagnosis: Multistage Recommendation Tracking. AJR Am J Roentgenol. 2017;209:970-975 pubmed publisher
    ..Unknown follow-up compliance is a risk factor for delay in diagnosis, a form of preventable medical error commonly identified in malpractice claims involving radiologists and office-based practitioners. ..
  71. Richaud C, de Lastours V, Panhard X, Petrover D, Bruno F, Lefort A. Candida vertebral osteomyelitis (CVO) 28 cases from a 10-year retrospective study in France. Medicine (Baltimore). 2017;96:e7525 pubmed publisher
    ..04).CVO concerns patients with serious underlying conditions and risk-factors for invasive candidiasis. Prolonged antifungal treatment appears to improve survival without sequelae. ..
  72. Tronconi G, Caiulo S, Di Frenna M, Vigone M, Chiumello G, Weber G. Rare cases of autoimmune hypothyroidism in young children. J Pediatr Endocrinol Metab. 2013;26:963-6 pubmed publisher
    ..Our cases highlight that AT may remain undiagnosed for a long time in young children owing to the rarity of the disease. ..
  73. DePasse J, Ruttiman R, Eltorai A, Palumbo M, Daniels A. Assessment of malpractice claims due to spinal epidural abscess. J Neurosurg Spine. 2017;27:476-480 pubmed publisher
    ..Additionally, paralysis is linked to large sums awarded to the plaintiff. Nonsurgeon physicians, who are often responsible for initial diagnosis, were more likely to be sued than were surgeons. ..
  74. Mezuki S, Shono Y, Akahoshi T, Hisanaga K, Saeki H, Nakashima Y, et al. Esophageal perforation due to blunt chest trauma: Difficult diagnosis because of coexisting severe disturbance of consciousness. Am J Emerg Med. 2017;35:1790.e3-1790.e5 pubmed publisher
    ..b>Delayed diagnosis may result in a fatal clinical course due to mediastinitis and subsequent sepsis...
  75. Kane E, Howell D, Smith A, Crouch S, Burton C, Roman E, et al. Emergency admission and survival from aggressive non-Hodgkin lymphoma: A report from the UK's population-based Haematological Malignancy Research Network. Eur J Cancer. 2017;78:53-60 pubmed publisher
    ..Emergency presentation impacts negatively on DLBCL survival; patients presenting via this route have significantly poorer outcomes than patients with similar clinical characteristics who present via other routes. ..
  76. Hamilton W. Emergency admissions of cancer as a marker of diagnostic delay. Br J Cancer. 2012;107:1205-6 pubmed publisher
  77. Alves Soares Ferreira N, Melo Figueiredo de Carvalho S, Engrácia Valenti V, Pinheiro Bezerra I, Melo Teixeira Batista H, de Abreu L, et al. Treatment delays among women with breast cancer in a low socio-economic status region in Brazil. BMC Womens Health. 2017;17:13 pubmed publisher
    ..It was commonly observed that, even after diagnosis, the patients needed to wait too long before entering the Oncology Service because of long waiting queues in the public health system. ..
  78. Bonadonna L, Saunders M, Zegarra R, Evans C, Alegria Flores K, Guio H. Why wait? The social determinants underlying tuberculosis diagnostic delay. PLoS ONE. 2017;12:e0185018 pubmed publisher
    ..In high-burden settings, more human and material resources are required to promote tuberculosis case-finding initiatives, reduce tuberculosis associated stigma and address the social determinants underlying diagnostic delay. ..
  79. Xie J, Hsieh E, Sun M, Wang H, Lv W, Fan H, et al. Delays in HIV diagnosis and associated factors among patients presenting with advanced disease at a tertiary care hospital in Beijing, China. PLoS ONE. 2017;12:e0182335 pubmed publisher
    b>Delayed diagnosis of HIV infection is associated with advanced immunosuppression and increased risk of onward transmission...
  80. Glass G, Tzafetta K. Optimising treatment of Bell's Palsy in primary care: the need for early appropriate referral. Br J Gen Pract. 2014;64:e807-9 pubmed publisher
  81. Saracoglu K, Acar A, Kuzucuoglu T, Yakupoglu S. Delayed diagnosis of white phosphorus burn. Burns. 2013;39:825-6 pubmed publisher
  82. Paez M, Gramelspacher A, Sinacore J, Winterfield L, Venu M. Delay in Diagnosis of Celiac Disease in Patients Without Gastrointestinal Complaints. Am J Med. 2017;130:1318-1323 pubmed publisher
    ..997). Although there is growing awareness of celiac disease, the delay in diagnosis for patients without gastrointestinal symptoms remains prolonged, with an average delay of 3.5 years. ..