Identification of undiagnosed inflammatory arthritis in a community health fair screen.
Identification of undiagnosed inflammatory arthritis in a community health fair screen.
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DOI：
10.1002/art.24834
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发表时间：
2009-12-15
影响因子：
--
通讯作者：
Holers, V. Michael
中科院分区：
文献类型：
--
作者：
Deane, Kevin D.;Striebich, Christopher C.;Goldstein, Barbara L.;Derber, Lezlie A.;Parish, Mark C.;Feser, Marie L.;Hamburger, Elaine M.;Brake, Stacey;Belz, Cindy;Goddard, James;Norris, Jill M.;Karlson, Elizabeth W.;Holers, V. Michael
本研究的主要目的是：1）在社区健康公平筛查中识别患有未诊断的炎性关节炎（IA）和类风湿性关节炎（RA）的个体，以及2）在健康公平环境中建立结缔组织疾病筛查问卷（CSQ）和IA自身抗体检测组合的诊断准确性。使用CSQ、关节检查、类风湿因子（RF）和抗环瓜氨酸（抗CCP）抗体检测的组合，在健康中心进行IA/RA筛查。IA定义为由经过培训的临床医生进行关节检查时，关节肿胀≥1处，提示滑膜炎。筛选了601例受试者; 51.0%因关节症状（疼痛、僵硬或肿胀）参与。84例受试者（14.0%）在关节检查时有≥1个关节肿胀，被指定为IA。在筛选的601例受试者中，9例（1.5%）患有IA，符合美国风湿病学会7项RA标准中的≥4项，但既往未诊断为RA，15例（2.5%）患有IA和RF和/或抗CCP阳性，提示早期RA。CSQ和自身抗体检测的组合用于鉴定IA的诊断准确性产生了最大的灵敏度、特异性、阳性和阴性预测值，分别为95.3%、99.2%、71.4%和97.7%。健康公平筛查可能是识别未确诊IA/RA患者的有效方法。CSQ和自身抗体检测的组合单独具有临床上有用的诊断准确性IA的检测。关于使用哪种方法进行未来健康公平IA/RA筛查的决定将取决于筛查和资助的目标。
The primary goals of this study were: 1) to identify individuals with undiagnosed inflammatory arthritis (IA) and rheumatoid arthritis (RA) in a community health-fair screen, and 2) to establish in a health-fair setting the diagnostic accuracy of combinations of the Connective Tissue Disease Screening Questionnaire (CSQ) and autoantibody testing for IA. Screening for IA/RA was performed at health-fair sites using a combination of CSQ, joint examination, rheumatoid factor (RF) and anti-cyclic citrullinated (anti-CCP) antibody testing. IA was defined as ≥1 swollen joint/s suggestive of synovitis on joint examination by a trained clinician. Six-hundred one subjects were screened; 51.0% participating because of joint symptoms (pain, stiffness, or swelling). Eighty-four subjects (14.0%) had ≥1 swollen joint/s designated as IA on joint examination. Of the 601 subjects screened, 9 (1.5%) had IA and met ≥4 of 7 American College of Rheumatology criteria for RA but had no prior diagnosis of RA, and 15 (2.5%) had IA and RF and/or anti-CCP positivity, suggesting early RA. The diagnostic accuracy of combinations of CSQ and autoantibody testing for the identification of IA yielded maximal sensitivity, specificity, positive and negative predictive values of 95.3%, 99.2%, 71.4%, and 97.7%, respectively. Health-fair screening may be an effective approach for the identification of individuals with undiagnosed IA/RA. A combination of CSQ and autoantibody testing alone has clinically useful diagnostic accuracy for the detection of IA. Decisions regarding which methodology to use for future health-fair IA/RA screening will depend on goals of screening and funding.
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影响因子：
--
作者：
Goekoop-Ruiterman, YPM;de Vries-Bouwstra, JK;Dijkmans, C
通讯作者：
Dijkmans, C
影响因子：
2.3
作者：
Cush, JJ
通讯作者：
Cush, JJ
影响因子：
37.8
作者：
Alberti, K. G. M. M.;Eckel, Robert H.;Smith, Sidney C., Jr.
通讯作者：
Smith, Sidney C., Jr.
影响因子：
1.9
作者：
LANDIS, JR;KOCH, GG
通讯作者：
KOCH, GG
影响因子：
27.4
作者：
Gabriel, S. E.
通讯作者：
Gabriel, S. E.