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How diseases such as Parkinson’s could be detected 10 years earlier with a ‘diagnostic window’

Chronic conditions including Parkinson’s and coeliac disease could be detected up to a decade earlier using patients’ healthcare records, a study suggests.

By analysing data such as records of GP appointments, symptoms, and test results, medics may be able to spot patterns and changes that could speed up diagnosis, researchers said.

The paper, published in the British Journal of General Practice, reviewed existing evidence of how patients’ healthcare changed in the months and years before being diagnosed with a range of conditions. 

It found that, for chronic conditions such as Parkinson’s disease, coeliac disease, schizophrenia, and inflammatory bowel disease (including ulcerative colitis and Crohn’s disease), healthcare use – ie visits to GPs and hospitals – increased up to 10 years before diagnosis.

For relatively acute conditions, such as tuberculosis and stroke, the change in healthcare use occurred only shortly before diagnosis – between one and six months.

The paper, which has been published in preprint, suggests that evidence of changing healthcare could theoretically be used as a tool in early diagnosis. 

But further research is required to investigate how this could be achieved, the researchers from University College London said.

The concept of a conditons’ “diagnostic window” – the timeframe in which a diagnosis may be possible – has previously been applied to cancer research.

But the UCL research, which looked at 27 studies containing evidence of healthcare changes before diagnosis, is thought to be the first time it has been applied to other conditions.

Lead author Emma Whitfield said: “In the last 20 years, researchers have put much time and effort into improving the diagnosis of cancer. A body of literature has built up with novel concepts, such as the ‘diagnostic window’, that haven’t been comprehensively applied to other diseases, and this was the motivation for our study.

“The next step is to analyse comprehensive datasets to determine the length of these diagnostic windows with more certainty. More detailed information about the type of changes in healthcare use before diagnosis can provide new avenues for inquiry as to how earlier diagnosis might be achieved.

“This initial evidence suggests that, if improvements can be made to the diagnostic process, there is potential to diagnose some patients with these conditions earlier.”

Senior co-author Professor Georgios Lyratzopoulos said: “This study suggests that, in a similar way to what has been found with different types of cancer, diagnostic windows may exist for many other health conditions. The findings hold promise for efforts to improve diagnosis in medicine.”

Claire Bale, head of research communications and engagement at Parkinson’s UK, said: “Parkinson’s is a neurodegenerative condition that develops slowly, probably over many years or even decades.

“By the time recognisable symptoms appear – like tremor, slowness and stiffness – major damage has already been done making it very difficult to stop or reverse the condition. If we can diagnose earlier, that will give us a much better chance to intervene to stop the damage that is occurring in the brain.

“Research shows that there are early warning signs that could enable us to spot Parkinson’s earlier. These can include things like loss of sense of smell, constipation, changes in sleep and mood.”

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