Performance of screening tools for psoriatic arthritis: a cross-sectional study in primary care

Maren C. Karreman; Angelique E. A. M. Weel; Myrthe van der Ven; Marijn Vis; Ilja Tchetverikov; Tamar E. C. Nijsten; Marlies Wakkee; Johanna M. W. Hazes; Jolanda J. Luime

doi:10.1093/rheumatology/kew410

Performance of screening tools for psoriatic arthritis: a cross-sectional study in primary care

Maren C. Karreman, Angelique E. A. M. Weel, Myrthe van der Ven, Marijn Vis, Ilja Tchetverikov, Tamar E. C. Nijsten, Marlies Wakkee, Johanna M. W. Hazes, Jolanda J. Luime

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Abstract

OBJECTIVE: . To compare the screening performance of the Psoriasis Epidemiology Screening Tool (PEST), Psoriatic Arthritis Screening and Evaluation (PASE) and Early Arthritis for Psoriatic Patients (EARP) questionnaires for detecting PsA among psoriasis patients in a primary care setting.

METHODS: In a cross-sectional study, 473 primary care psoriasis patients at risk for PsA completed the PEST, PASE and EARP questionnaires and were clinically evaluated by a trained research nurse. A PsA case was defined by a rheumatologist according to the CASPAR criteria. Sensitivity and specificity were determined for the PEST and EARP cut-offs (⩾3) and the PASE cut-offs (⩾44 and ⩾47).

RESULTS: PsA was diagnosed in 53 patients. The PEST had a sensitivity of 0.68 and a specificity of 0.71. The PASE was validated for two different cut-offs. The cut-off of 47 led to a sensitivity of 0.59 and a specificity of 0.66, whereas the lower cut-off of 44 led to a sensitivity of 0.66 and a specificity of 0.57. For the EARP we found a sensitivity of 0.87 with a specificity of 0.34.

CONCLUSION: The PEST questionnaire has the most favourable trade-off between sensitivity and specificity to screen for PsA. However, as the prevalence of psoriasis and PsA is fairly low in primary care, screening only psoriasis patients with musculoskeletal complaints may be a better allocation of resources.

Original language	English
Pages (from-to)	597-602
Number of pages	6
Journal	Rheumatology
Volume	56
Issue number	4
DOIs	https://doi.org/10.1093/rheumatology/kew410
Publication status	Published - Apr 2017

Bibliographical note

Funding:
This study was financially funded by an investigator-initiated grant from Pfizer BV. The company had no
influence on study design, collection of data, analysis or
interpretation of data, nor on the preparation or approval
of the manuscript and the decision to submit the manuscript for publication.

© The Author 2016. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

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Cite this

@article{1248aded9c51481383375fa4ae14630d,

title = "Performance of screening tools for psoriatic arthritis: a cross-sectional study in primary care",

abstract = "OBJECTIVE: . To compare the screening performance of the Psoriasis Epidemiology Screening Tool (PEST), Psoriatic Arthritis Screening and Evaluation (PASE) and Early Arthritis for Psoriatic Patients (EARP) questionnaires for detecting PsA among psoriasis patients in a primary care setting.METHODS: In a cross-sectional study, 473 primary care psoriasis patients at risk for PsA completed the PEST, PASE and EARP questionnaires and were clinically evaluated by a trained research nurse. A PsA case was defined by a rheumatologist according to the CASPAR criteria. Sensitivity and specificity were determined for the PEST and EARP cut-offs (⩾3) and the PASE cut-offs (⩾44 and ⩾47).RESULTS: PsA was diagnosed in 53 patients. The PEST had a sensitivity of 0.68 and a specificity of 0.71. The PASE was validated for two different cut-offs. The cut-off of 47 led to a sensitivity of 0.59 and a specificity of 0.66, whereas the lower cut-off of 44 led to a sensitivity of 0.66 and a specificity of 0.57. For the EARP we found a sensitivity of 0.87 with a specificity of 0.34.CONCLUSION: The PEST questionnaire has the most favourable trade-off between sensitivity and specificity to screen for PsA. However, as the prevalence of psoriasis and PsA is fairly low in primary care, screening only psoriasis patients with musculoskeletal complaints may be a better allocation of resources.",

author = "Karreman, {Maren C.} and Weel, {Angelique E. A. M.} and {van der Ven}, Myrthe and Marijn Vis and Ilja Tchetverikov and Nijsten, {Tamar E. C.} and Marlies Wakkee and Hazes, {Johanna M. W.} and Luime, {Jolanda J.}",

note = "Funding: This study was financially funded by an investigator-initiated grant from Pfizer BV. The company had no influence on study design, collection of data, analysis or interpretation of data, nor on the preparation or approval of the manuscript and the decision to submit the manuscript for publication. {\textcopyright} The Author 2016. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com",

year = "2017",

month = apr,

doi = "10.1093/rheumatology/kew410",

language = "English",

volume = "56",

pages = "597--602",

journal = "Rheumatology",

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T1 - Performance of screening tools for psoriatic arthritis

T2 - a cross-sectional study in primary care

AU - Karreman, Maren C.

AU - Weel, Angelique E. A. M.

AU - van der Ven, Myrthe

AU - Vis, Marijn

AU - Tchetverikov, Ilja

AU - Nijsten, Tamar E. C.

AU - Wakkee, Marlies

AU - Hazes, Johanna M. W.

AU - Luime, Jolanda J.

N1 - Funding: This study was financially funded by an investigator-initiated grant from Pfizer BV. The company had no influence on study design, collection of data, analysis or interpretation of data, nor on the preparation or approval of the manuscript and the decision to submit the manuscript for publication. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

PY - 2017/4

Y1 - 2017/4

N2 - OBJECTIVE: . To compare the screening performance of the Psoriasis Epidemiology Screening Tool (PEST), Psoriatic Arthritis Screening and Evaluation (PASE) and Early Arthritis for Psoriatic Patients (EARP) questionnaires for detecting PsA among psoriasis patients in a primary care setting.METHODS: In a cross-sectional study, 473 primary care psoriasis patients at risk for PsA completed the PEST, PASE and EARP questionnaires and were clinically evaluated by a trained research nurse. A PsA case was defined by a rheumatologist according to the CASPAR criteria. Sensitivity and specificity were determined for the PEST and EARP cut-offs (⩾3) and the PASE cut-offs (⩾44 and ⩾47).RESULTS: PsA was diagnosed in 53 patients. The PEST had a sensitivity of 0.68 and a specificity of 0.71. The PASE was validated for two different cut-offs. The cut-off of 47 led to a sensitivity of 0.59 and a specificity of 0.66, whereas the lower cut-off of 44 led to a sensitivity of 0.66 and a specificity of 0.57. For the EARP we found a sensitivity of 0.87 with a specificity of 0.34.CONCLUSION: The PEST questionnaire has the most favourable trade-off between sensitivity and specificity to screen for PsA. However, as the prevalence of psoriasis and PsA is fairly low in primary care, screening only psoriasis patients with musculoskeletal complaints may be a better allocation of resources.

AB - OBJECTIVE: . To compare the screening performance of the Psoriasis Epidemiology Screening Tool (PEST), Psoriatic Arthritis Screening and Evaluation (PASE) and Early Arthritis for Psoriatic Patients (EARP) questionnaires for detecting PsA among psoriasis patients in a primary care setting.METHODS: In a cross-sectional study, 473 primary care psoriasis patients at risk for PsA completed the PEST, PASE and EARP questionnaires and were clinically evaluated by a trained research nurse. A PsA case was defined by a rheumatologist according to the CASPAR criteria. Sensitivity and specificity were determined for the PEST and EARP cut-offs (⩾3) and the PASE cut-offs (⩾44 and ⩾47).RESULTS: PsA was diagnosed in 53 patients. The PEST had a sensitivity of 0.68 and a specificity of 0.71. The PASE was validated for two different cut-offs. The cut-off of 47 led to a sensitivity of 0.59 and a specificity of 0.66, whereas the lower cut-off of 44 led to a sensitivity of 0.66 and a specificity of 0.57. For the EARP we found a sensitivity of 0.87 with a specificity of 0.34.CONCLUSION: The PEST questionnaire has the most favourable trade-off between sensitivity and specificity to screen for PsA. However, as the prevalence of psoriasis and PsA is fairly low in primary care, screening only psoriasis patients with musculoskeletal complaints may be a better allocation of resources.

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JF - Rheumatology

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Performance of screening tools for psoriatic arthritis: a cross-sectional study in primary care

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