How Does Gender Affect Diagnosis of Ankylosing Spondylitis?

In a recent study, researchers explored the contrasts in experiences between men and women diagnosed with ankylosing spondylitis (AS) and found differences in both the number and composition of health event coding in the 2 years prior to diagnosis.

Researchers analyzed the MarketScan databases claims data from January 2006 to April 2019 focusing on patients with 2 or more AS diagnoses, a minimum of 30 days apart, as well as 2 years of insurance enrollment prior to analysis of diagnosis.

Statistically significant differences between men and women were observed among 274 of 1906 AS-related codes in 7744 patients. Researchers noted that across providers and diagnoses, women received more diagnosis codes than men.

Peripheral symptom coding (57.7% vs 43.9%) revealed the largest difference in diagnosis codes among women compared to men.

“More women than men received diagnosis codes for depression (21.2% vs 9.8%) and other musculoskeletal symptoms (52.8% vs 40.0%); only gout was more common in men (6.5%) than in women (2.2%),” wrote researchers.

Backache codes gradually increased 12 months preceding AS diagnosis among men, but a sharp increase in axial and sacroiliitis coding was immediate, prior to diagnosis.

Researchers noted 64.2% of women had visits with rheumatologists vs 45.1% of men.

“Further investigation into the dissimilarities in diagnostic experiences between men and women is needed to determine whether differences are due to disease phenotype or potential cognitive bias influencing diagnostic decision-making,” concluded study authors.

Reference:
Hwang MC, Rozycki M, Kauffman D, Arndt T, Yi E, Weisman MH. Does gender impact a diagnosis of ankylosing spondylitis? ACR Open Rheumatol. Published online March 29, 2022. doi:10.1002/acr2.11428