FRI0397 The Diagnostic Value of The Symptom of Inflammatory Back Pain in Axial Spondyloarthritis in The Rheumatology Setting
| Autor: | Joachim Listing, Denis Poddubnyy, Inge Spiller, J. Sieper, J. Braun, M. Rudwaleit |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Inflammatory back pain Immunology Population Primary care Likelihood ratios in diagnostic testing General Biochemistry Genetics and Molecular Biology 03 medical and health sciences 0302 clinical medicine Rheumatology Internal medicine medicine Back pain Immunology and Allergy 030212 general & internal medicine Axial spondyloarthritis education 030203 arthritis & rheumatology Ankylosing spondylitis education.field_of_study business.industry medicine.disease Physical therapy medicine.symptom business |
| Zdroj: | Annals of the Rheumatic Diseases. 75:578.3-579 |
| ISSN: | 1468-2060 0003-4967 |
| DOI: | 10.1136/annrheumdis-2016-eular.2892 |
| Popis: | Background Inflammatory back pain (IBP) as a symptom has been shown to perform effectively for selecting patients in primary care/orthopaedic settings for referral of chronic back pain patients to the rheumatologist for further diagnostic work-up. IBP is also being used as a diagnostic test of axial spondyloarthritis (axSpA) by rheumatologists, but no validations studies have been performed so far with IBP as a diagnostic tool. Objectives The aim of the DIVERS study was to evaluate the diagnostic value of the IBP symptom in axSpA in the rheumatology setting. Methods A total of 405 consecutive patients referred to a rheumatologist because of chronic back pain starting at an age Results The diagnosis of definite axSpA was made in 180 (44.4%) patients (88 with ankylosing spondylitis and 92 with non-radiographic axSpA). The sensitivity, specificity and the positive likelihood ratio of IPB for the axSpA diagnosis was 81%, 44%, and 1.5, respectively, if globally assessed by the blinded rheumatologist, and 90%, 58% and 2.2, respectively, if globally assessed by the diagnosing rheumatologist - table. There was no clear superiority of any of the three criteria sets regarding sensitivity for the axSpA diagnosis with an overall sensitivity of about 80% and specificity between 25% and 45% if symptoms were assessed by a rheumatologist - table. The performance of the criteria sets based on patient9s own evaluation of IBP symptoms was generally lower. No single IBP parameter showed superiority regarding sensitivity or specificity in comparison to the criteria sets. Conclusions IBP demonstrated high sensitivity but rather modest specificity for the diagnosis of axSpA among patients with chronic back pain referred to a rheumatologist. A resulting moderate diagnostic value of IBP in the rheumatology setting is likely to be counterbalanced by increase in the pre-test probability of axSpA in this patients population. Disclosure of Interest None declared |
| Databáze: | OpenAIRE |
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