Additional File 1 s10

Additional file 1:

Table S1: Characteristics of samples not-included in meta-analyses

Table S2: Characteristics of articles additionally included for GCA-specific characteristic analysis

Table S3: Article quality appraisal scores using the Newcastle-Ottawa Scale (NOS)

Figure S1: Meta-analysis of time-periods of delay in receiving a diagnosis of GCA (Original SD only)

Figure S2: Meta-analysis of time-periods of delay in receiving a diagnosis of GCA (Imputed SD only)

Figure S3: Meta-analysis of time-periods of delay in receiving a diagnosis of GCA (GCA diagnosis through TAB only)

1 Table S1: Characteristics of samples not-included in meta-analyses Gender Age Reported diagnostic delay Lead author Definition of GCA n % F Mean SD Range Time Mean SD Range Positive TAB for GCA after fever was initial Calamia 15 66.7 67 - 57-75 M 3* - 1-16 symptom Positive TAB for GCA and/or study defined Karanjia 63 - - - - D 52 - - clinical criteria Positive TAB for GCA and/or study defined Kelkel 130 74.6 76 7.5 60-92 M 5* - 0.5-48 clinical criteria Positive TAB for GCA or on clinical Hu 16 6.3 43.1 - 28-60 M 5.5 - 0.25-24.3 grounds (response to steroids) Nuenninghoff GCA defined using 1990 ACR criteria 168 79.2 75.6 - D 40* - 21-89 Loddenkemper Positive TAB for GCA 90 74.4 74.6 7.8 - D 125* 2-2555

ACR = American College of Rheumatology. Time: D = days, W= weeks & M = months. TAB = Temporal Artery Biopsy. *Reported as median

Table S2: Characteristics of articles additionally included for GCA-specific characteristic analysis Gender Age Reported diagnostic delay

2 Defin ition Mean Lead author n % F Mean SD SD Range of (Weeks) GCA Positi ve TAB for GCA 42 54.8 75.1 6.7 9.6 11 - with visual manif estati ons Gonzalez-Gay Positi ve TAB for GCA witho 119 47.1 74.6 6.9 11.5 13 - ut visual manif estati ons Bilate ral blind Schmidt 5 60 81.6 - 7 3* 2-14 ness from GCA Gonzalez-Gay GCA, 29 62.1 74.3 7.5 8 4* 4-20 but negati

3 ve TAB Positi ve TAB 161 50.9 74.8 6.8 7 1.7* 4-14 for GCA Positi ve TAB 97 - 74.5 6.6 9.7 13 - for GCA – Men Positi ve TAB for 113 53.8 74.7 7.3 11.0 10 - GCA – Femal Gonzalez-Gay e Positi ve TAB 132 46.2 74.0 6.7 9.9 12 - for GCA – Rural Positi ve TAB 78 66.7 75.6 7.3 11.1 11 - for GCA – Urban Gonzalez-Gay Positi 203 53.2 74.7 6.7 9.2 9.9 - ve

4 TAB for GCA – With heada che Positi ve TAB for GCA – 37 59.5 75.2 6.9 16.6 15 - Witho ut heada che Positi ve TAB for 96 60.4 73.4 6.3 13.4 12 - GCA – With PMR Positi ve TAB for 144 50 75.6 6.9 8.3 10 - GCA – Witho ut PMR Subcli nical 18 66.7 75.6 5.9 16.3 15 - GCA Biops 222 53.2 74.7 6.8 9.9 11 -

5 y- prove n GCA Positi ve TAB for 46 52.2 13.2 12.8 GCA - <69 years Lopez-Diaz 75.1 6.8 Positi ve TAB for 227 53.7 9.4 10.2 GCA - ≥70 years

ACR = American College of Rheumatology. ESR = Erythrocyte Sedimentation Rate. PMR = Polymyalgia Rheumatica. Time: D = days, W= weeks & M = months. MRR = Medical Record Review; TAB = Temporal Artery Biopsy. *SD imputed from range

Table S3: Article quality appraisal scores using the Newcastle-Ottawa Scale (NOS)

Selection Outcome Article Year 1 3 1 Is exposed cohort How was exposed How was representative? cohort selected? outcome assessed? Calamia 1981 B* A* B* Bella Cueto* 1985 B* A* D Karanjia 1989 B* A* B* Desmet* 1990 B* A* B*

6 Kelkel 1991 B* A* B* Myklebust* 1996 A* A* B* Brack* 1999 B* A* B* Duhaut* 1999 A* A* B* Nesher* 1999 B* A* A Hu 2002 B* A* D Liozon* 2003 B* A* B* Nuenninghoff 2003 A* A* B* Gonzalez-Gay* 2004 B* A* B* Pease* 2005 B* B* B* Loddenkemper 2007 B* A* B* Mari* 2009 B* A* B* Ezeonyeji* 2011 B* A* B* Mackie* 2011 A* A* B* Czihal* 2012 B* A* B* Prieto-Gonzalez* 2012 B* A* B* Patil* 2015 A* A* B* Singh* 2015 A* A* B* Gonzalez-Gayǂ 2000 A* A* B* Schmidtǂ 2000 C D D Gonzalez-Gay 2001 A* A* B* Gonzalez-Gay 2003 A* A* B* Gonzalez-Gayǂ 2005 A* A* B*

7 Lopez-Diaz 2008 A* A* B* *Included in delay meta-analyses. ǂIncluded in characteristic-specific delay meta-analysis. A indicates the highest methodological quality whereas D indicates the worst quality; An asterisk (*) denotes that the article has scored highest for that particular criterion. A comma (,) separating two scores denotes that an article i) matched exposed and non-exposed and ii) adjusted for potential confounding factors

8 % Figure S1: Meta-analysis of time-periods of delay in receiving a diagnosis of GCA (Original SD only)

author year country n ES (95% CI) Weight

Desmet 1990 Belgium 21 1.21 (0.53, 1.90) 13.15

Liozon 2003 France 175 11.29 (9.52, 13.05) 12.81

Gonzalez-Gay 2004 Spain 199 9.80 (8.30, 11.30) 12.92

Mackie 2011 England 248 9.14 (7.40, 10.89) 12.82

Czihal 2012 Germany 110 18.20 (14.13, 22.27) 11.30

Prieto-Gonzalez 2012 Spain 40 10.60 (6.60, 14.60) 11.36

Patil 2015 England 46 4.57 (2.95, 6.19) 12.87

Singh 2015 USA 204 5.90 (4.04, 7.76) 12.76

Overall (I-squared = 97.5%, p = 0.000) 8.65 (5.05, 12.25) 100.00

with estimated predictive interval . (-4.51, 21.80)

NOTE: Weights are from random effects analysis

0 30 Figure S2: Meta-analysis of time-periods of delay in receiving a diagnosis of GCA (Imputed SD only) %

author year country n ES (95% CI) Weight

Bella Cueto 1985 Spain 100 18.00 (7.81, 28.19) 4.62

Myklebust 1996 Norway 39 6.43 (4.17, 8.69) 15.87

Brack 1999 USA 74 11.14 (9.44, 12.85) 16.78

Nesher 1999 Israel 144 6.43 (5.14, 7.72) 17.34

Duhaut 1999 France 207 6.86 (0.02, 13.70) 7.83

Pease 2005 England 42 12.86 (5.81, 19.90) 7.56

Mari 2009 Spain 79 13.14 (10.59, 15.70) 15.32

Ezeonyeji 2011 England 65 5.00 (2.11, 7.89) 14.69

Overall (I-squared = 84.6%, p = 0.000) 9.09 (6.56, 11.63) 100.00

with estimated predictive interval . (1.01, 17.17)

0 30 Figure S3: Meta-analysis of time-periods of delay in receiving a diagnosis of GCA (GCA diagnosis through TAB only) % author year country n ES (95% CI) Weight

Bella Cueto 1985 Spain 100 18.00 (7.81, 28.19) 4.49

Desmet 1990 Belgium 21 1.21 (0.53, 1.90) 9.33

Myklebust 1996 Norway 39 6.43 (4.17, 8.69) 8.90

Brack 1999 USA 74 11.14 (9.44, 12.85) 9.10

Duhaut 1999 France 207 6.86 (0.02, 13.70) 6.30

Liozon 2003 France 175 11.29 (9.52, 13.05) 9.08

Gonzalez-Gay 2004 Spain 199 9.80 (8.30, 11.30) 9.16

Mari 2009 Spain 79 13.14 (10.59, 15.70) 8.78

Ezeonyeji 2011 England 65 5.00 (2.11, 7.89) 8.62

Mackie 2011 England 248 9.14 (7.40, 10.89) 9.09

Prieto-Gonzalez 2012 Spain 40 10.60 (6.60, 14.60) 8.03

Patil 2015 England 46 4.57 (2.95, 6.19) 9.13

Overall (I-squared = 96.7%, p = 0.000) 8.55 (5.55, 11.54) 100.00 with estimated predictive interval . (-3.08, 20.17)