Alexandre Sepriano1, Robert Landewé2, Désirée van der Heijde3, Joachim Sieper4, Nurullah Akkoc5, Jan Brandt6, Jürgen Braun7, Eduardo Collantes-Estevez8, Maxime Dougados9, Oliver Fitzgerald10, Feng Huang11, Jieruo Gu12, Yesim Kirazli13, Walter P Maksymowych14, Helena Marzo-Ortega15, Ignazio Olivieri16, Salih Ozgocmen17, Euthalia Roussou18, Salvatore Scarpato19, Inge J Sørensen20, Rafael Valle-Oñate21, Filip Van den Bosch22, Irene van der Horst-Bruinsma23, Ulrich Weber24, James Wei25, Martin Rudwaleit26. 1. Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands Department of Rheumatology, Hospital de Egas Moniz-CHLO, Lisbon, Portugal. 2. Departments of Clinical Immunology & Rheumatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands Department of Rheumatology, Atrium Medical Center, Heerlen, The Netherlands. 3. Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. 4. Department of Rheumatology, Med Klinik I, Charité Campus Benjamin Franklin, Berlin, Germany German Rheumatism Research Centre, Berlin, Germany. 5. Department of Rheumatology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey. 6. Department of Rheumatology, Private Practice, Berlin, Germany. 7. Rheumazentrum Ruhrgebiet, Herne, Germany. 8. Rheumatology Department, "Reina Sofia" Hospital/IMIBIC/University of Córdoba, Córdoba, Spain. 9. Rheumatology Department, Paris Descartes University, Cochin Hospital, Paris, France. 10. Department of Rheumatology, St Vincent's University Hospital, Dublin, Elm Park, Ireland. 11. Department of Rheumatology, Chinese PLA General Hospital, Beijing, China. 12. Department of Rheumatology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. 13. Department of Physical Medicine and Rehabilitation, Medical Faculty of Ege University, Izmir, Turkey. 14. Department of Medicine, University of Alberta, Edmonton, Alberta, Canada. 15. Leeds Institute of Rheumatic and Musculoskeletal Medicine, Chapel Allerton Hospital, University of Leeds, Leeds, UK. 16. Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Potenza, Italy. 17. Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Erciyes University, School of Medicine, Gevher Nesibe Hospital, Kayseri, Turkey. 18. Department of Rheumatology and Rehabilitation, King George's Hospital, London, UK. 19. Rheumatology Unit, M. Scarlato Hospital, Scafati, Salerno, Italy. 20. Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, Glostrup, Denmark Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. 21. Division of Rheumatology, Department of Internal Medicine, Hospital Militar Central, Bogotá, Colombia. 22. Department of Rheumatology, Ghent University Hospital, Ghent, Belgium. 23. Department of Rheumatology, VU University Medical Centre, Amsterdam, Netherlands. 24. King Christian 10th Hospital for Rheumatic Diseases, Gråsten, and South Jutland Hospital, Denmark Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark. 25. Chung Shan Medical University Hospital, Taichung, Taiwan. 26. Klinikum Bielefeld, Berlin, Germany Charité University Medicine, Berlin, Germany.
Abstract
OBJECTIVE: To establish the predictive validity of the Assessment of SpondyloArthritis international Society (ASAS) spondyloarthritis (SpA) classification criteria. METHODS: 22 centres (N=909 patients) from the initial 29 ASAS centres (N=975) participated in the ASAS-cohort follow-up study. Patients had either chronic (>3 months) back pain of unknown origin and age of onset below 45 years (N=658) or peripheral arthritis and/or enthesitis and/or dactylitis (N=251). At follow-up, information was obtained at a clinic visit or by telephone. The positive predictive value (PPV) of the baseline classification by the ASAS criteria was calculated using rheumatologist's diagnosis at follow-up as external standard. RESULTS: In total, 564 patients were assessed at follow-up (345 visits; 219 telephone) with a mean follow-up of 4.4 years (range: 1.9; 6.8) and 70.2% received a SpA diagnosis by the rheumatologist. 335 patients fulfilled the axial SpA (axSpA) or peripheral SpA (pSpA) criteria at baseline and of these, 309 were diagnosed SpA after follow-up (PPV SpA criteria: 92.2%). The PPV of the axSpA and pSpA criteria was 93.3% and 89.5%, respectively. The PPV for the 'clinical arm only' was 88.0% and for the 'clinical arm'±'imaging arm' 96.0%, for the 'imaging arm only' 86.2% and for the 'imaging arm'+/-'clinical arm' 94.7%. A series of sensitivity analyses yielded similar results (range: 85.1-98.2%). CONCLUSIONS: The PPV of the axSpA and pSpA criteria to forecast an expert's diagnosis of 'SpA' after more than 4 years is excellent. The 'imaging arm' and 'clinical arm' of the axSpA criteria have similar predictive validity and are truly complementary. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
OBJECTIVE: To establish the predictive validity of the Assessment of SpondyloArthritis international Society (ASAS) spondyloarthritis (SpA) classification criteria. METHODS: 22 centres (N=909 patients) from the initial 29 ASAS centres (N=975) participated in the ASAS-cohort follow-up study. Patients had either chronic (>3 months) back pain of unknown origin and age of onset below 45 years (N=658) or peripheral arthritis and/or enthesitis and/or dactylitis (N=251). At follow-up, information was obtained at a clinic visit or by telephone. The positive predictive value (PPV) of the baseline classification by the ASAS criteria was calculated using rheumatologist's diagnosis at follow-up as external standard. RESULTS: In total, 564 patients were assessed at follow-up (345 visits; 219 telephone) with a mean follow-up of 4.4 years (range: 1.9; 6.8) and 70.2% received a SpA diagnosis by the rheumatologist. 335 patients fulfilled the axial SpA (axSpA) or peripheral SpA (pSpA) criteria at baseline and of these, 309 were diagnosed SpA after follow-up (PPV SpA criteria: 92.2%). The PPV of the axSpA and pSpA criteria was 93.3% and 89.5%, respectively. The PPV for the 'clinical arm only' was 88.0% and for the 'clinical arm'±'imaging arm' 96.0%, for the 'imaging arm only' 86.2% and for the 'imaging arm'+/-'clinical arm' 94.7%. A series of sensitivity analyses yielded similar results (range: 85.1-98.2%). CONCLUSIONS: The PPV of the axSpA and pSpA criteria to forecast an expert's diagnosis of 'SpA' after more than 4 years is excellent. The 'imaging arm' and 'clinical arm' of the axSpA criteria have similar predictive validity and are truly complementary. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Authors: U Kiltz; J Braun; A Becker; J-F Chenot; M Dreimann; L Hammel; A Heiligenhaus; K-G Hermann; R Klett; D Krause; K-F Kreitner; U Lange; A Lauterbach; W Mau; R Mössner; U Oberschelp; S Philipp; U Pleyer; M Rudwaleit; E Schneider; T L Schulte; J Sieper; A Stallmach; B Swoboda; M Winking Journal: Z Rheumatol Date: 2019-12 Impact factor: 1.372
Authors: Miranda van Lunteren; Alexandre Sepriano; Robert Landewé; Joachim Sieper; Martin Rudwaleit; Désirée van der Heijde; Floris van Gaalen Journal: Arthritis Res Ther Date: 2018-08-03 Impact factor: 5.156