Diagnostic delay of myositis: protocol for an integrated systematic review

Tergel Namsrai; Jane Desborough; Anita Chalmers; Christine Lowe; Matthew Cook; Christine Phillips; Anne Parkinson

doi:10.1136/bmjopen-2021-060312

Diagnostic delay of myositis: protocol for an integrated systematic review

BMJ Open. 2022 Jun 13;12(6):e060312. doi: 10.1136/bmjopen-2021-060312.

Authors

Tergel Namsrai¹, Jane Desborough², Anita Chalmers^{1

3}, Christine Lowe^{1

3}, Matthew Cook⁴, Christine Phillips⁵, Anne Parkinson¹

Affiliations

¹ National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia.
² National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia jane.desborough@anu.edu.au.
³ Myositis Australia Inc, Canberra, Australian Capital Territory, Australia.
⁴ The John Curtin School of Medical Research, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia.
⁵ School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia.

Abstract

Introduction: Idiopathic inflammatory myopathies (IIM). described as 'inflammatory myositis', are a heterogeneous group of rare muscular autoimmune diseases characterised by skeletal muscle inflammation. Its complex characteristics with lack of accurate diagnostic tests, unified classification system and comprehensive widely used diagnostic criteria could lead to diagnostic delay. This study will review diagnostic delay in myositis and provide an overview and clearer insight of patients' experiences, causes and consequences of diagnostic delay in myositis.

Methods and analysis: The literature source will be a systematic search of PubMed/MEDLINE, Scopus, ProQuest and sources of grey literature, conducted from database inception to December 2021 without restrictions on publication date. All study types (qualitative and quantitative) except review articles, examining diagnostic delay, incorrect diagnosis, missed diagnosis or slow diagnosis of all types of myositis in all ages will be included. Evidence of patients' experiences associated with diagnostic delay will also be examined. Studies in languages other than English, German and Indonesian will be excluded. Outcomes will be diagnostic delay time, patients' experiences, and causes and consequences associated with diagnostic delay in myositis. Two review authors will independently screen the titles and abstracts of search results against the inclusion criteria. The Mixed Methods Appraisal Tool (MMAT) will be used to appraise selected studies. Two independent authors will extract data using a prepiloted data extraction tool. If sufficient quantitative data is available, a meta-analysis will be conducted along with subgroup analysis including pooled diagnostic delay in each type of myositis. Qualitative data will be analysed in line with meta-aggregation methods. If data is insufficient, a narrative synthesis will be conducted.

Ethics and dissemination: As this work is a systematic review, ethical approval was not required. Findings of the study will be disseminated through publications in peer-reviewed journals, conferences and symposia.

Prospero registration number: CRD42022289830.

Keywords: preventive medicine; public health; quality in health care.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Delayed Diagnosis*
Humans
Indonesia
Meta-Analysis as Topic
Myositis* / diagnosis
Research Design
Systematic Reviews as Topic