{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T21:08:52Z","timestamp":1790024932216,"version":"4.0.1"},"reference-count":15,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100018952","name":"NIHR Birmingham Biomedical Research Centre","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100018952","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/05ccjmp23","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/100013963","name":"University Hospitals Birmingham NHS Foundation Trust","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100013963","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/014ja3n03","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000855","name":"University of Birmingham","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000855","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/03angcq70","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Delays in diagnosis are unfortunately quite common in most health systems. It is apparent that timely diagnosis is more likely to have a favourable outcome. However, there may be many reasons why timely diagnosis is not always achieved. The aim of our study was to report on the impact of delays on IBD-related adverse outcomes (AOs). Methods: New patients referred for suspected IBD to a single tertiary care centre between January 2013 to December 2017 were identified using EMR. For purposes of the study, a cut-off time was set by investigators for each delay-type based on best average hospital waiting times. The reasons for delays in patient journey until start of treatment and data on pre-defined AOs (steroid &amp; other rescue therapies, hospitalisations, surgery) were recorded for each patient until end of June 2021. The data were analysed using multiple Pearson correlations and Cox proportional Hazard model to determine whether there is a difference in survival without AOs between patients with and without a delay. Results: Total of 105 patients were identified using stringent criteria (M = 58; median age = 32 y) with a long median follow-up of 55 months. 65, 27 and 13 patients had final diagnosis of Ulcerative colitis, Crohn\u2019s disease and Unclassified colitis respectively, and analysed collectively. In our cohort, the longest delay-types noted were\u2014patients seeking medical attention (median = 4 months; range 1 to 84 months), arranging gastroenterology clinic review after referral from primary care (median = 5 weeks; range 1 to 30 weeks), and waiting for index endoscopy (median = 3 weeks; 1 to 36 weeks). Patient stratification based on delay-type using specific cut-off times for each showed a statistically significant difference in survival without AOs for all (when comparing delay v\/s no delay). Conclusions: In our cohort we report that delays, and subsequent untreated chronic inflammation, leads to poor outcomes in patients with newly diagnosed IBD regardless of whether delays are patient-related or health-system-related. Also, cumulative delays in the hospital appear to increase the use of biologics in consecutive years. Understanding these factors help rectify and offer long-term solutions.<\/jats:p>","DOI":"10.3390\/diagnostics16071043","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T12:11:59Z","timestamp":1774872719000},"page":"1043","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Delayed Diagnosis in IBD on Clinical Outcomes and Healthcare Delivery"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6800-584X","authenticated-orcid":false,"given":"Uday N.","family":"Shivaji","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham B15 2TT, UK"},{"name":"Department of Gastroenterology, Mazumdar Shaw Medical Centre, Narayana Health City, Bangalore 560099, India"},{"name":"Department of Gastroenterology, University Hospitals Birmingham, NHS Foundation Trust, Birmingham B15 2GW, UK"},{"name":"National Institute for Health Research (NIHR), Birmingham Biomedical Research Centre, University Hospitals Birmingham, BirminghamB15 2GW, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Snehali","family":"Majumder","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham B15 2TT, UK"},{"name":"Department of Clinical Research, Narayana Health City, Bangalore 560099, India"},{"name":"APC Microbiome Ireland, College of Medicine and Health, University College Cork, T12 K8AF Cork, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhishek","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University Hospitals Birmingham, NHS Foundation Trust, Birmingham B15 2GW, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina","family":"Bazarova","sequence":"additional","affiliation":[{"name":"Biological Physics, Institute for Biological Physics, University of Cologne, 50923 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommaso L.","family":"Parigi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham B15 2TT, UK"},{"name":"Department of Gastroenterology, University Hospitals Birmingham, NHS Foundation Trust, Birmingham B15 2GW, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1713-7797","authenticated-orcid":false,"given":"Subrata","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham B15 2TT, UK"},{"name":"Department of Gastroenterology, University Hospitals Birmingham, NHS Foundation Trust, Birmingham B15 2GW, UK"},{"name":"National Institute for Health Research (NIHR), Birmingham Biomedical Research Centre, University Hospitals Birmingham, BirminghamB15 2GW, UK"},{"name":"APC Microbiome Ireland, College of Medicine and Health, University College Cork, T12 K8AF Cork, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marietta","family":"Iacucci","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham B15 2TT, UK"},{"name":"Department of Gastroenterology, University Hospitals Birmingham, NHS Foundation Trust, Birmingham B15 2GW, UK"},{"name":"National Institute for Health Research (NIHR), Birmingham Biomedical Research Centre, University Hospitals Birmingham, BirminghamB15 2GW, UK"},{"name":"APC Microbiome Ireland, College of Medicine and Health, University College Cork, T12 K8AF Cork, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.crohns.2007.06.005","article-title":"Impact of inflammatory bowel disease on quality of life: Results of the European Federation of Crohn\u2019s and Ulcerative Colitis Associations (EFCCA) patient survey","volume":"1","author":"Ghosh","year":"2007","journal-title":"J. Crohns Colitis"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1016\/j.cgh.2006.03.003","article-title":"The Manitoba Inflammatory Bowel Disease Cohort Study: Prolonged symptoms before diagnosis\u2014How much is irritable bowel syndrome?","volume":"4","author":"Burgmann","year":"2006","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1002\/ibd.21719","article-title":"Systematic evaluation of risk factors for diagnostic delay in inflammatory bowel disease","volume":"18","author":"Vavricka","year":"2012","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Moon, C.M., Jung, S.A., Kim, S.E., Song, H.J., Jung, Y., Ye, B.D., Cheon, J.H., Kim, Y.S., Kim, Y.-H., and Kim, J.S. (2015). Clinical Factors and Disease Course Related to Diagnostic Delay in Korean Crohn\u2019s Disease Patients: Results from the CONNECT Study. 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Hepatol."},{"key":"ref_15","first-page":"A95","article-title":"PMO-37 COVID-19 impact on care and prescribing for inflammatory bowel disease: Data from the IBD Registry","volume":"70","author":"Bodger","year":"2021","journal-title":"Gut"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/7\/1043\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T16:01:22Z","timestamp":1775059282000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/7\/1043"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,30]]},"references-count":15,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["diagnostics16071043"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16071043","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,30]]}}}