{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T05:09:32Z","timestamp":1790831372654,"version":"4.1.0"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,3,6]],"date-time":"2020-03-06T00:00:00Z","timestamp":1583452800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,3,6]],"date-time":"2020-03-06T00:00:00Z","timestamp":1583452800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Rheumatol"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Early diagnosis and treatment of Juvenile Idiopathic Arthritis (JIA) is essential to optimize outcomes. Wait times (WTs) to consultation with a pediatric rheumatologist consultation is a Canadian quality measure, with benchmarks set at 7\u2009days for systemic JIA (sJIA) and 4\u2009weeks for other JIA categories. In this study we assess WTs for JIA at a single academic center and describe factors associated with longer WTs.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>This was a retrospective cohort study of 164 patients enrolled in a pharmacogenetic study in Alberta between 2002 and 2018. Limited chart reviews were conducted to evaluate dates of referral and first rheumatology visit to calculate WTs for receipt of pediatric rheumatology care. Cox proportional hazard models identified factors associated with WTs considering variables at the first pediatric rheumatology visit including: JIA category, age, sex, distance to the pediatric rheumatology clinic, number of active joints, pain and C-reactive protein.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The median age at diagnosis was 8.0\u2009years (interquartile range, IQR 3.5, 12.0) and 46% of patients had oligoarticular JIA. Only 18 patients (11%) were from rural locations. The median WT for all patients met the national benchmark (22\u2009days, IQR, 9, 44) with no statistically significant difference between WTs among JIA categories (<jats:italic>p<\/jats:italic>\u2009=\u20090.055). Importantly, the majority of sJIA cases met the 7-day benchmark (67%) with a median WT of 1.5\u2009days. Older age was associated with longer WT (HR 0.94, 95% CI 0.89, 0.98, <jats:italic>p<\/jats:italic>\u2009=\u20090.005).<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Median benchmarks were met, however delays in older patients highlight the need for monitoring WTs.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12969-020-0413-7","type":"journal-article","created":{"date-parts":[[2020,3,6]],"date-time":"2020-03-06T05:03:49Z","timestamp":1583471029000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Patient factors associated with waiting time to pediatric rheumatologist consultation for patients with juvenile idiopathic arthritis"],"prefix":"10.1186","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3062-5488","authenticated-orcid":false,"given":"Claire E. H.","family":"Barber","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3761-237X","authenticated-orcid":false,"given":"Cheryl","family":"Barnabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Benseler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricky","family":"Chin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Johnson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Luca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paivi","family":"Miettunen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1954-2822","authenticated-orcid":false,"given":"Marinka","family":"Twilt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dwaraka","family":"Veeramreddy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie J.","family":"Shiff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heinrike","family":"Schmeling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,3,6]]},"reference":[{"key":"413_CR1","unstructured":"O\u2019Donnell S, McRae L, Toews J, Pelletier L, CDDSS Arthritis Working Group. National surveillance of arthritis in Canada, results from the Canadian Chronic Disease Surveillance System (CCDSS). J Rheumatol. 2019;46(7):794."},{"key":"413_CR2","volume-title":"Candian Chronic Disease Surveillance System (CCDSS)","author":"Public Health Agency of Canada","year":"2018","unstructured":"Public Health Agency of Canada. Candian Chronic Disease Surveillance System (CCDSS). 2018. URL: https:\/\/infobase.phac-aspc.gc.ca\/CCDSS-SCSMC\/data-tool\/."},{"key":"413_CR3","doi-asserted-by":"publisher","first-page":"1077","DOI":"10.1002\/art.24539","volume":"61","author":"K Oen","year":"2009","unstructured":"Oen K, Tucker L, Huber AM, Miettunen P, Scuccimarri R, Campillo S, et al. Predictors of early inactive disease in a juvenile idiopathic arthritis cohort: results of a Canadian multicenter, prospective inception cohort study. Arthritis Rheum. 2009;61:1077\u201386.","journal-title":"Arthritis Rheum"},{"key":"413_CR4","doi-asserted-by":"publisher","first-page":"530","DOI":"10.3899\/jrheum.150839","volume":"43","author":"CE Barber","year":"2016","unstructured":"Barber CE, Marshall DA, Mosher DP, Akhavan P, Tucker L, Houghton K, et al. Development of system-level performance measures for evaluation of models of care for inflammatory arthritis in Canada. J Rheumatol. 2016;43:530\u201340.","journal-title":"J Rheumatol"},{"key":"413_CR5","volume-title":"Time to close the gap: report card on WTs in Canada (2014)","author":"Wait Time Alliance (WTA)","year":"2014","unstructured":"Wait Time Alliance (WTA). Time to close the gap: report card on WTs in Canada (2014). 2014. URL: http:\/\/www.waittimealliance.ca\/wta-reports\/2014-wta-report-card\/."},{"key":"413_CR6","first-page":"390","volume":"31","author":"RE Petty","year":"2004","unstructured":"Petty RE, Southwood TR, Manners P, Baum J, Glass DN, Goldenberg J, et al. International league of associations for rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001. J Rheumatol. 2004;31:390\u20132.","journal-title":"J Rheumatol"},{"key":"413_CR7","first-page":"559","volume":"32","author":"R Merino","year":"2005","unstructured":"Merino R, de Inocencio J, Garcia-Consuegra J. Evaluation of revised international league of associations for rheumatology classification criteria for juvenile idiopathic arthritis in Spanish children (Edmonton 2001). J Rheumatol. 2005;32:559\u201361.","journal-title":"J Rheumatol"},{"key":"413_CR8","volume-title":"ArcMap: types of network analysis layers","author":"Esri","year":"2019","unstructured":"Esri. ArcMap: types of network analysis layers. 2019. URL: http:\/\/desktop.arcgis.com\/en\/arcmap\/latest\/extensions\/network-analyst\/types-of-network-analyses.htm."},{"key":"413_CR9","volume-title":"Population centre and rural area classification 2016","author":"Statistics Canada","year":"2016","unstructured":"Statistics Canada. Population centre and rural area classification 2016. 2016. URL: https:\/\/www.statcan.gc.ca\/eng\/subjects\/standard\/pcrac\/2016\/introduction."},{"issue":"6","key":"413_CR10","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1016\/j.jbspin.2019.04.014","volume":"86","author":"Caroline Freychet","year":"2019","unstructured":"Freychet C, Lambert C, Pereira B, Stephan JL, Echaubard S, Merlin E, et al. Medical pathways of children with juvenile idiopathic arthritis before referral to pediatric rheumatology centers. Joint Bone Spine. 2019;86(6):739\u201345.","journal-title":"Joint Bone Spine"},{"issue":"12","key":"413_CR11","doi-asserted-by":"publisher","first-page":"2203","DOI":"10.1093\/rheumatology\/ket273","volume":"52","author":"Akhila Kavirayani","year":"2013","unstructured":"Kavirayani A, Foster HE. Paediatric rheumatology practice in the UK benchmarked against the British Society for paediatric and adolescent rheumatology\/arthritis and musculoskeletal alliance standards of care for juvenile idiopathic arthritis. Rheumatology (Oxford). 2013;52(12):2203\u20137.","journal-title":"Rheumatology"},{"key":"413_CR12","doi-asserted-by":"publisher","first-page":"1367","DOI":"10.1002\/art.24671","volume":"61","author":"N Tzaribachev","year":"2009","unstructured":"Tzaribachev N, Benseler SM, Tyrrell PN, Meyer A, Kuemmerle-Deschner JB. Predictors of delayed referral to a pediatric rheumatology center. Arthritis Rheum. 2009;61:1367\u201372.","journal-title":"Arthritis Rheum"},{"key":"413_CR13","doi-asserted-by":"publisher","first-page":"2415","DOI":"10.3899\/jrheum.100083","volume":"37","author":"NJ Shiff","year":"2010","unstructured":"Shiff NJ, Tucker LB, Guzman J, Oen K, Yeung RS, Duffy CM. Factors associated with a longer time to access pediatric rheumatologists in Canadian children with juvenile idiopathic arthritis. J Rheumatol. 2010;37:2415\u201321.","journal-title":"J Rheumatol"}],"container-title":["Pediatric Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12969-020-0413-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12969-020-0413-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12969-020-0413-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,6]],"date-time":"2021-03-06T00:45:52Z","timestamp":1614991552000},"score":1,"resource":{"primary":{"URL":"https:\/\/ped-rheum.biomedcentral.com\/articles\/10.1186\/s12969-020-0413-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,6]]},"references-count":13,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["413"],"URL":"https:\/\/doi.org\/10.1186\/s12969-020-0413-7","relation":{},"ISSN":["1546-0096"],"issn-type":[{"value":"1546-0096","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,3,6]]},"assertion":[{"value":"8 October 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 February 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 March 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"All patients in the study provided written informed consent and the study was approved by the University of Calgary Research Ethics Board (REB15\u20130998).","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable, there is no individual identifying images or personal data presented. Patients consented and the study was approved by the University of Calgary Research Ethics board as described above.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"22"}}