Volume 32, Number 5—May 2026
CME ACTIVITY - Research
Frequency and Duration of Diagnostic Delays Associated with Coccidioidomycosis and Risk Factors for Missed Diagnoses, United States
Desmond D. Barber, Alan T. Arakkal, George R. Thompson, John W. Baddley, Joe E. Cavanaugh, Aaron C. Miller, and Philip M. Polgreen
Table 3
Simulation results for number and duration of delayed visits per patient in study of frequency and duration of diagnostic delays associated with coccidioidomycosis and risk factors for missed diagnoses, United States *
| Metric | Value | 95% CI |
|---|---|---|
| No. (%) missed opportunities per patient | ||
| ≥1 | 16,061 (59.7%) | 15,685–16,445 (58.3%–61.1%) |
| ≥2 | 9,770 (36.3%) | 9,312–10,238 (34.6%–38.1%) |
| ≥3 | 5,824 (21.6%) | 5,408–6,281 (20.1%–23.3%) |
| ≥4 | 3,491 (13.0%) | 3,159–3,849 (11.7%–14.3%) |
| ≥5 | 2,183 (8.1%) | 1,935–2,447 (7.2%–9.1%) |
| Mean | 2.70 | 2.58–2.81 |
| Median |
2.00 |
2.00–2.00 |
| Duration of delayed visits, d | ||
| ≥1 | 16,061 (59.7%) | 15,685–16,445 (58.3%–61.1%) |
| ≥3 | 15,113 (56.2%) | 14,724–15,516 (54.7%–57.7%) |
| ≥7 | 13,780 (51.2%) | 13,376–14,213 (49.7%–52.8%) |
| ≥10 | 12,453 (46.3%) | 12,027–12,895 (44.7%–47.9%) |
| ≥14 | 11,187 (41.6%) | 10,738–11,625 (39.9%–43.2%) |
| ≥21 | 9,050 (33.6%) | 8,570–9,534 (31.9%–35.4%) |
| ≥30 | 6,650 (24.7%) | 6,169–7,177 (22.9%–26.7%) |
| ≥45 | 3,930 (14.6%) | 3,458–4,447 (12.9%–16.5%) |
| ≥60 | 2,150 (8.0%) | 1,781–2,580 (6.6%–9.6%) |
| ≥90 | 153 (0.6%) | 82–229 (0.3%–0.9%) |
| Mean delay duration, d | 29.69 | 28.25–31.18 |
| Median delay duration, d | 24.05 | 23.00–26.00 |
*The distribution and mean number of potential missed diagnostic opportunities each patient experienced along with the distribution and mean and median duration of diagnostic delays (in days) are presented. Potential missed diagnostic opportunities represent healthcare visits in which sign/symptoms were present, but coccidioidomycosis was not diagnosed. Delay duration was defined as the time between the earliest potential missed diagnostic opportunity a patient experienced and their index diagnosis.
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Page updated: May 11, 2026
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