Abstract
Objective
To explore association between misdiagnosis of IC/BPS and demographics. Interstitial
cystitis/bladder pain syndrome (IC/BPS) is associated with significant diagnostic
uncertainty, resulting in frequent misdiagnosis as there is little known about the
potential impact of key demographic factors.
Methods
All patients in the VA system between 1999-2016 were identified by ICD-9/10 codes
for IC/BPS (595.1/N30.10) (n = 9,503). ICD code accuracy for true IC/BPS (by strict
criteria) was assessed by in-depth chart abstraction (n = 2,400). Associations were
explored between rates of misdiagnosis and demographics.
Results
IC/BPS criteria were met in only 651 (48.8%) of the 1,334 charts with an ICD code
for IC/BPS reviewed in depth. There were no differences in the misdiagnosis rate by
race (P=.27) or by ethnicity (P=.97), after adjusting for differences in age and gender. In IC/BPS-confirmed cases,
female patients were diagnosed at a younger age than males (41.9 vs. 58.2 years, P<.001). Black and Hispanic patients were diagnosed at a younger age compared to White
(41.9 vs. 50.2 years, P<.001) and non-Hispanic patients, respectively (41.1 vs. 49.1 years, P=.002).
Conclusion
There was a high rate of misdiagnosis of IC/BPS overall, with only 48.8% of patients
with an ICD code for IC/BPS meeting diagnostic criteria. There were no significant
associations between diagnostic accuracy and race/ethnicity. Black and Hispanic patients
were more likely to receive a diagnosis of IC/BPS at a younger age, suggesting there
may be differing natural histories or presentation patterns of IC/BPS between racial/ethnic
groups.
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Article info
Publication history
Published online: August 02, 2021
Accepted:
July 19,
2021
Received:
April 5,
2021
Footnotes
Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Identification
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© 2021 Published by Elsevier Inc.
