{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T10:38:44Z","timestamp":1788431924536,"version":"build-2803163510"},"reference-count":30,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T00:00:00Z","timestamp":1750636800000},"content-version":"unspecified","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,6,10]]},"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>A delayed diagnosis of pituitary adenomas (PAs) can lead to increased morbidity and reduced quality of life. The aim was to estimate diagnostic delay and investigate the concordance between patient-reported symptoms and the medical record documentation in patients with PA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Seven university hospitals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>654 patients: non-functioning PA (NFPA, 314), prolactinoma (118), acromegaly (164) and Cushing\u2019s Disease (CD, 58).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data collection<\/jats:title>\n                    <jats:p>Questionnaires and medical record extraction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcomes<\/jats:title>\n                    <jats:p>Type of first healthcare contact, delay of PA diagnosis and patient-reported symptoms and symptoms documented in medical records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      First healthcare contact was usually a general practitioner. Estimated time from symptoms to diagnosis varied from &lt;1 year (66%), 1\u20135 years (12%), 5\u20139 years (13%) and &gt;10 years (9%). The longest diagnostic delays were observed in acromegaly and CD. A longer delay was observed in women compared with men (p&lt;0.001). The most frequent patient-reported symptoms among NFPA were headache and visual disturbances; for prolactinomas, menstrual irregularities and headache; for acromegaly, change in appearance and snoring; and for CD, weight gain and tiredness. Concordance between patient-reported symptoms at diagnosis and medical records was found for visual disturbances in NFPA and prolactinomas (\n                      <jats:italic>Cohen\u2019s<\/jats:italic>\n                      kappa &gt;0.6) and for menstrual irregularities in prolactinomas (\n                      <jats:italic>Cohen\u2019s<\/jats:italic>\n                      kappa &gt;0.7).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We report a large variation in symptom duration before diagnosis with a substantial diagnostic delay in patients with CD and acromegaly. An increased awareness about endocrine diseases in the general population and health professionals may contribute to earlier diagnosis of pituitary adenomas.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-097804","type":"journal-article","created":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T14:20:27Z","timestamp":1750688427000},"page":"e097804","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Estimating diagnostic delay in patients with pituitary adenomas in Sweden: a cross-sectional study"],"prefix":"10.1136","volume":"15","author":[{"given":"Maria","family":"Forsgren","sequence":"first","affiliation":[{"name":"Department of Medical Sciences; Endocrinology and Mineral Metabolism, Uppsala University Hospital, Uppsala, Stockholm, 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