% 0期刊文章%一个萨拉LaHue %凯萨琳Albers %撒母耳Jeffrey Klingman高盛% % Raymond Lo %一个紫水晶Leimpeter康尼马拉% %一个凯萨琳Comyns罗宾Fross % % Zhuqin Gu %一个玛雅Katz %劳里Ozelius %一个瑞秋Saunders-Pullman苏珊Bressman % %辛西娅·考米拉% Lorene Nelson %一个斯蒂芬·范Eeden %卡罗琳·坦纳% T颈肌张力障碍(CD)发病率和诊断延误一个多民族的健康维护组织。(S36.004) % D J神经病学20首页15% % P S36.004 % V 84% N % X 14补充目的:确定发病率和描述诊断延迟的颈肌张力障碍(CD)在一个大型的、多民族的综合健康维护组织。背景:很少有CD发病率的研究。诊断的延迟没有得到系统的研究。设计/方法:CD病例中使用电子病历回顾> 300万名Kaiser Permanente加州北部(KPNC) 2003 - 2007。最后的诊断是由两个运动障碍专家的共识。发病率是标准化使用2000年美国人口普查。诊断延迟是评估通过比较医生访问CD之前诊断或一个等价的时间控制(索引日期)。控制匹配对年龄、性别和会员持续时间(1例:10控制)。使用逻辑回归调整优势比测定年龄,性别和会员持续时间。 The frequency and impact of diagnostic delay were assessed by structured interviews in a subgroup. RESULTS: CD incidence standardized to the US 2000 Census population was 1.18/100,000 person-years (p-y) , (95[percnt] C.I.: 0.35, 2.0; women: 0.93, men: 0.25) based on 200 cases over 15.4 million p-y. Incidence increased with age through the 7th decade. CD diagnosis was delayed a median of 730 days. Diagnoses more common in CD vs. controls before index date included essential tremor (OR 68.1, 95[percnt] C.I. 28.2, 164.5), cervical disk disease (OR 3.83, 95[percnt] C.I. 2.83,5.17), neck sprain/strain (OR 2.68 , 95[percnt] C.I. 1.99, 3.62), anxiety (OR 2.24, 95[percnt] C.I. 1.63,3.11) and depression (OR 1.94, 95[percnt] C.I. 1.4, 2.68 ). 50[percnt] of CD patients interviewed reported diagnostic delay; of these, 75[percnt] had difficulties at work and 48[percnt] difficulties with family relationships due to the delay. CONCLUSIONS: CD incidence is higher in women. Diagnostic delay is common, with adverse impacts. Diagnoses preceding CD may reflect comorbid conditions, diagnostic errors or etiologic factors. Support: NIH-1RO1-NS046340, AHRQ-RO1-HS018413, Dystonia Medical Research Foundation, KPNC, James & Sharron ClarkDisclosure: Dr. LaHue has nothing to disclose. Dr. Albers has nothing to disclose. Dr. Goldman has nothing to disclose. Dr. Klingman has nothing to disclose. Dr. Lo has nothing to disclose. Dr. Marras has received personal compensation for activities with EMD Serono. Dr. Leimpeter has nothing to disclose. Dr. Fross has nothing to disclose. Dr. Comyns has nothing to disclose. Dr. Gu has nothing to disclose. Dr. Katz has received personal compensation for activities with Medtronic. Dr. Ozelius has nothing to disclose., Dr. Bressman has nothing to disclose. Dr. Saunders-Pullman has nothing to disclose. Dr. Comella has received personal compensation for activities with Ipsen, Merz, Allergan, Inc., Medtronic, Inc., Teva, US World Meds, Impax, and Acadia. Dr. Comella's institution has received research support from Ipsen, Merz, Allergan, Inc., the National Dr. Nelson has received personal compensation for activities with NeuroPace and Acumen, LLC. Dr. Van Den Eeden has received research support from Abbott Molecular, GlaxoSmithKline, and Takeda Pharmaceutical Company. Dr. Tanner has received personal compensation for activities with Pfizer Inc. as a consultant.Wednesday, April 22 2015, 4:00 pm-5:45 pm %U