{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:53:52Z","timestamp":1786978432500,"version":"build-2736575974"},"reference-count":28,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2015,1,13]],"date-time":"2015-01-13T00:00:00Z","timestamp":1421107200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Little is known about diagnostic interval lengths in childhood cancer, their predictors or impact upon survival. To date, studies have relied on questionnaires or chart abstraction. We aimed to construct and validate a diagnostic interval measure using health services data among children with acute lymphoblastic leukemia (ALL) in order to determine predictors of prolonged intervals and associations with event\u2010free survival (EFS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Procedure<\/jats:title>\n                    <jats:p>All children with ALL diagnosed 1995\u20132011 (N\u2009=\u20091,541) in Ontario, Canada were linked to population\u2010based health administrative databases. Healthcare claims prior to diagnosis were used to define healthcare episodes. Diagnostic intervals (time between first episode with diagnostic code a priori classified as consistent with underlying ALL, and diagnosis) were validated by correlation with a chart abstraction\u2010based measure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Intervals were generally short (median 2 days, IQR 1\u20133). Predictors of longer intervals included having general primary care physicians versus pediatricians (odds ratio 1.60, 95%CI 1.04\u20132.47;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.03). While prolonged diagnostic intervals were associated with superior EFS (hazard ratio 0.71, 95%CI 0.52\u20130.98;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.04), this was explained by confounding by disease biology.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Health administrative data can be used to measure diagnostic intervals in ALL and potentially other pediatric malignant and non\u2010malignant diseases. Diagnostic intervals were short and a marker of disease severity rather than independent predictors of outcome. These findings may be used to address caregiver guilt and caution against \u201cearly diagnosis\u201d benchmarks not based in evidence. Future studies should examine the impact of diagnostic interval length in other conditions, but should account for potential confounding by disease severity. Pediatr Blood Cancer 2015;62:957\u2013963. \u00a9 2015 Wiley Periodicals, Inc.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pbc.25402","type":"journal-article","created":{"date-parts":[[2015,1,13]],"date-time":"2015-01-13T21:02:07Z","timestamp":1421182927000},"page":"957-963","source":"Crossref","is-referenced-by-count":20,"title":["Predictors of diagnostic interval and associations with outcome in acute lymphoblastic leukemia"],"prefix":"10.1002","volume":"62","author":[{"given":"Sumit","family":"Gupta","sequence":"first","affiliation":[{"name":"Division of Haematology\/Oncology and Program in Child Health Evaluative Sciences Hospital for Sick Children Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Gibson","sequence":"additional","affiliation":[{"name":"Department of Pediatrics London Health Sciences Centre London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason D","family":"Pole","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Group of Ontario Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rinku","family":"Sutradhar","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences Toronto Canada"},{"name":"Dalla Lana School of Public Health University of Toronto Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lillian","family":"Sung","sequence":"additional","affiliation":[{"name":"Division of Haematology\/Oncology and Program in Child Health Evaluative Sciences Hospital for Sick Children Toronto Canada"},{"name":"Institute of Health Policy, Management and Evaluation University of Toronto Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid","family":"Guttmann","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences Toronto Canada"},{"name":"Institute of Health Policy, Management and Evaluation University of Toronto Toronto Canada"},{"name":"Division of Paediatric Medicine Hospital for Sick Children Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,1,13]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6605384"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(12)70050-5"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(12)70041-4"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2012.68"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1258\/jhsrp.2011.010113"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(13)70588-6"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(12)70361-3"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.11004"},{"key":"e_1_2_7_10_1","volume-title":"Canadian Institute for Health Information Discharge Abstract Database: A Validation Study","author":"Juurlink 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