scholarly journals OP0305 VALIDATION OF THE PSORIASIS EPIDEMIOLOGY SCREENING TOOL (PEST) AND THE NEW EARLY ARTHRITIS FOR PSORIATIC PATIENTS (EARP) IN PEDIATRIC POPULATION - PILOT STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 187.2-187
Author(s):  
Y. Butbul
Keyword(s):  
Psoriatic Arthritis ◽  
Sensitivity And Specificity ◽  
Pediatric Patients ◽  
Screening Tool ◽  
Pediatric Population ◽  
Joint Damage ◽  
High Sensitivity ◽  
Early Arthritis ◽  
Screening Tools ◽  
Questionnaire Score

Background:Juvenile Psoriatic Arthritis (JPsA) is an inflammatory arthritis associated with irreversible joint damage among the pediatric population, which is associated with psoriasis in most cases.While there are few validated screening tools for diagnosis of arthritis for adult patients with psoriasis, those screening tools were never evaluated in children.Objectives:The aims of this study were to evaluate two screening tools among pediatric patients with psoriasis.Methods:Thirty-nine patients with the diagnosis of psoriasis were administered two screening questionnaires: the new Early Arthritis for Psoriatic Patients (EARP) questionnaire and the Psoriatic Arthritis Screening and Evaluation (PASE) questionnaire.All patients were evaluated by a rheumatologist for the diagnosis of JPsA, and the accuracy of the two questionnaires compared.Results:The 4/39 (10.1%) patients diagnosed with JPsA had a PEST questionnaire score of ≥ 3, compared to a median PEST score of the patients without the diagnosis of JPsA of 0 (0-2). Thus both the sensitivity and specificity of the PEST in diagnosing JPsA were 100%.For the EARP questionnaire, 8/39 patients had a screening questionnaire score of ≥ 3, suggestive of JPsA, four were true positive, and four false positive. Thus, the sensitivity and specificity of EARP in diagnosing JPsA were 100% and 89%, respectively.Conclusion:Both the PEST and EARP questionnaires were easy to use and had high sensitivity for pediatric population with psoriasis, however the PEST questionnaire had a higher specificity than the EARP.Disclosure of Interests:None declared.

scholarly journals Psoriatic arthritis screening: a systematic review and meta-analysis

Rheumatology ◽  
2018 ◽  
Vol 58 (4) ◽  
pp. 692-707 ◽  
Author(s):  
Nicolas Iragorri ◽  
Glen Hazlewood ◽  
Braden Manns ◽  
Vishva Danthurebandara ◽  
Eldon Spackman
Keyword(s):  
Systematic Review ◽  
Psoriatic Arthritis ◽  
Sensitivity And Specificity ◽  
Screening Tool ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Screening Tools ◽  
Screening Questionnaire ◽  
Psa Screening ◽  
Early Psoriatic Arthritis

Abstract Objective To systematically review the accuracy and characteristics of different questionnaire-based PsA screening tools. Methods A systematic review of MEDLINE, Excerpta Medical Database, Cochrane Central Register of Controlled Trials and Web of Science was conducted to identify studies that evaluated the accuracy of self-administered PsA screening tools for patients with psoriasis. A bivariate meta-analysis was used to pool screening tool-specific accuracy estimates (sensitivity and specificity). Heterogeneity of the diagnostic odds ratio was evaluated through meta-regression. All full-text records were assessed for risk of bias with the QUADAS 2 tool. Results A total of 2280 references were identified and 130 records were assessed for full-text review, of which 42 were included for synthesis. Of these, 27 were included in quantitative syntheses. Of the records, 37% had an overall low risk of bias. Fourteen different screening tools and 104 separate accuracy estimates were identified. Pooled sensitivity and specificity estimates were calculated for the Psoriatic Arthritis Screening and Evaluation (cut-off = 44), Psoriatic Arthritis Screening and Evaluation (47), Toronto Psoriatic Arthritis Screening (8), Psoriasis Epidemiology Screening Tool (3) and Early Psoriatic Arthritis Screening Questionnaire (3). The Early Psoriatic Arthritis Screening Questionnaire reported the highest sensitivity and specificity (0.85 each). The I2 for the diagnostic odds ratios varied between 76 and 90.1%. Meta-regressions were conducted, in which the age, risk of bias for patient selection and the screening tool accounted for some of the observed heterogeneity. Conclusions Questionnaire-based tools have moderate accuracy to identify PsA among psoriasis patients. The Early Psoriatic Arthritis Screening Questionnaire appears to have slightly better accuracy compared with the Toronto Psoriatic Arthritis Screening, Psoriasis Epidemiology Screening Tool and Psoriatic Arthritis Screening and Evaluation. An economic evaluation could model the uncertainty and estimate the cost-effectiveness of PsA screening programs that use different tools.

Dermatology Screening Tools: Project Update from the GRAPPA 2012 Annual Meeting

2013 ◽  
Vol 40 (8) ◽  
pp. 1425-1427 ◽  
Author(s):  
Dafna D. Gladman ◽  
Philip S. Helliwell ◽  
Majed Khraishi ◽  
Kristina Callis Duffin ◽  
Philip J. Mease
Keyword(s):  
Psoriatic Arthritis ◽  
Annual Meeting ◽  
Sensitivity And Specificity ◽  
Early Identification ◽  
High Sensitivity ◽  
Large Cohort ◽  
Screening Tools ◽  
Initial Validation ◽  
Screening Questionnaires

Several screening tools for early identification of psoriatic arthritis (PsA) have been developed. While these tools had high sensitivity and specificity during their development and initial validation, it remained to be determined how they would function with widespread use. At the 2012 annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) in Stockholm, Sweden, these tools were compared for their utility when used to screen patients for PsA in clinics other than those in which they were developed. The screening tools did not perform as well as previously published, and members suggested new tools may need to be developed. An additional study of the prevalence of PsA in a large cohort of psoriasis patients, the PREPARE study, which investigated the use of screening questionnaires, was also presented.

scholarly journals Recent advances in understanding and managing psoriatic arthritis

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 2670 ◽  
Author(s):  
Dafna D. Gladman
Keyword(s):  
Psoriatic Arthritis ◽  
Early Diagnosis ◽  
Clinical Laboratory ◽  
Joint Damage ◽  
Screening Tools ◽  
Therapeutic Interventions ◽  
Joint Disease ◽  
New Therapeutic Approaches ◽  
Recent Advances ◽  
And Function

This article reviews recent advances in psoriatic arthritis (PsA) over the past several years with emphasis on early diagnosis, better understanding of pathogenesis, and new therapeutic approaches. Early diagnosis is important, since people who present late do not fare as well. There are a number of clinical, laboratory, and ultrasound features that can help identify patients destined to develop PsA, and several screening tools have been developed. It is recognized that genetic and epigenetic factors, as well as T cells and cytokines, play a role in the pathogenesis of PsA, and several targets have been identified for therapeutic interventions. New therapies have been developed and tested in PsA and have been found to be highly effective for both skin and joint manifestations of the disease. The expectation is that, in the future, PsA patients will be treated early and more aggressively and that there will not be significant progression of joint damage. Moreover, with effective treatment of the skin and joint disease and management of risk factors for the comorbidities, we can expect to reduce their occurrence and further reduce the excess mortality and reduced quality of life and function in these patients.

scholarly journals Accuracy of STRONGKids to Identify Risk of Children Malnutrition in Sanjiwani General Hospital Gianyar, Bali

2021 ◽  
Vol 6 (1) ◽  
pp. 1-6
Author(s):  
Dewa Ngakan Putu Yogi Astika Yogi Astika
Keyword(s):  
General Hospital ◽  
Medical Record ◽  
Pediatric Patients ◽  
Healing Process ◽  
High Sensitivity ◽  
Test Method ◽  
Screening Tools ◽  
Chi Square ◽  
Cross Sectional ◽  
Hospital Malnutrition

Malnutrition in the hospital is a condition that needs to be watched out for because it affects the length of stay and healing process of hospitalized patients. Until now, the prevalence of malnutrition in the hospital is still high in both adult and pediatric patients. Malnutrition screening is required while the patient will be hospitalized. It is necessary to research the accuracy of STRONGKids (Screening tools for risk on nutritional status and growth) as a malnutrition screening in pediatric patients in hospitals, especially at Sanjiwani General Hospital Gianyar percentage of malnutrition in hospitals at Sanjiwani Gianyar Hospital so that they receive early treatment. The purpose of this study was to determine the accuracy of STRONGKids as a screening test for malnutrition in the hospital for children at Sanjiwani General Hospital Gianyar. This research uses a design cross-sectional by the diagnostic test method. Data taken from medical records. Data collection method with consecutive sampling. The number of samples is 40 subjects. The inclusion criteria were children aged one month - 18 years and hospitalized at Sanjiwani Gianyar Hospital. The exclusion criteria were incomplete medical record data, and subjects were categorized as obese or obese on the medical record. The data analysis technique used the SPSS computer program. STRONGKids data are presented in 2 x 2 table form Chi-square. The results obtained were the percentage of hospital malnutrition of 9.8%. STRONGKids with a cutoff value of 1 had a sensitivity of 100% and a specificity of 35.1%. So, the STRONGKids score has fairly high sensitivity, so that the use of the STRONGKids score in combination with anthropometric measurements can be used to detect malnutrition in hospitals. Keywords: sensitivity, STRONGKids, child malnutrition

Role of joint damage, malalignment and inflammation in articular tenderness in rheumatoid arthritis, psoriatic arthritis and osteoarthritis

2021 ◽  
pp. annrheumdis-2020-218744
Author(s):  
Irina Gessl ◽  
Mihaela Popescu ◽  
Victoria Schimpl ◽  
Gabriela Supp ◽  
Thomas Deimel ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Psoriatic Arthritis ◽  
Power Doppler ◽  
Joint Damage ◽  
Joint Space ◽  
Early Arthritis ◽  
Damage Score ◽  
Established Disease ◽  
Active Inflammation

ObjectivesTo determine whether clinical tenderness can be considered a sign of inflammatory joint activity in patients with rheumatoid arthritis (RA), osteoarthritis (OA) or psoriatic arthritis (PsA) and to assess other possible factors associated with tenderness.MethodsPatients diagnosed with RA, PsA and OA underwent clinical and ultrasound examination of wrists and finger joints. Radiographs of the hands were scored for erosions, joint space narrowing (JSN), osteophytes and malalignment. A binary damage score (positive if ≥1 erosion, JSN and/or presence of malalignment) was calculated. Differences in grey scale signs of synovitis and power Doppler (PD) between tender non-swollen (TNS) versus non-tender non-swollen (NTNS) joints were calculated. Disease duration was assessed,<2 years was regarded as early and >5 years as long-standing arthritis.ResultsIn total, 34 patients (9 early and 14 long-standing) from patients with RA, 31 patients (7 early and 15 long-standing) with PsA and 30 with OA were included. We found equal frequencies of PD signal between TNS and NTNS joints in RA (p=0.18), PsA (p=0.59) or OA (p=0.96). However, PD had a significant association with tenderness in early arthritis both in RA (p=0.02) and in PsA (p=0.02). The radiographic damage score showed significant association with tenderness in RA (p<0.01), PsA (p<0.01) and OA (p=0.04).ConclusionTenderness might not always be a sign of active inflammation in RA, PsA and OA. While tenderness in early arthritis may be more related to inflammation, established disease is better explained by joint damage and malalignment.

Developing the Thai Siriraj Psoriatic Arthritis Screening Tool and validating the Thai Psoriasis Epidemiology Screening Tool and the Early Arthritis for Psoriatic Patients questionnaire

2016 ◽  
Vol 36 (10) ◽  
pp. 1459-1468 ◽  
Author(s):  
Praveena Chiowchanwisawakit ◽  
Luksame Wattanamongkolsil ◽  
Varalak Srinonprasert ◽  
Chonachan Petcharat ◽  
Palanan Siriwanarangsun ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Screening Tool ◽  
Early Arthritis

scholarly journals PP12 New ‘nature of call’ telephone screening tool, employed prior to nhs pathways triage, can accurately identify those later treated for out of hospital cardiac arrest: analysis of sensitivity and specificity using routine ambulance service data

2019 ◽  
Vol 36 (1) ◽  
pp. e5.2-e5
Author(s):  
Jonathan Green ◽  
Sean Ewings ◽  
Richard Wortham ◽  
Bronagh Walsh
Keyword(s):  
Cardiac Arrest ◽  
Sensitivity And Specificity ◽  
Screening Tool ◽  
Early Recognition ◽  
High Sensitivity ◽  
Ambulance Service ◽  
Current Function ◽  
Ambulance Dispatch ◽  
Clinical Records ◽  
Hospital Cardiac Arrest

BackgroundA new pre-triage emergency medical call screening tool, Nature of Call (NoC), has been introduced into UK ambulance services which employ the NHS Pathways (NHSP) triage system. Its current function is to provide a rapid sieve, differentiating between patients who may need treatment for Out-of-Hospital Cardiac Arrest (OHCA), and therefore require immediate ambulance dispatch, and all other calls, for which ambulance dispatch is withheld whilst further triage is undertaken.ObjectiveTo evaluate the accuracy of NoC in identifying patients with potentially treatable OHCA or peri-arrest conditions.MethodsStudy of diagnostic accuracy. The sample was a retrospective cohort of consecutive calls to a UK ambulance service, taken over a four-month period. Sensitivity and specificity were determined, comparing allocated priority dispositions with an OHCA Treatment Registry. Context was supplied by the evaluation of subsequent categorisation by NHSP. The accuracy of the combined NoC and NHSP allocations was also investigated.ResultsA total of 1 87 419 emergency calls were received. Of these, 71 373 were allocated both NoC and NHSP priority dispositions and were associated with electronic Patient Clinical Records. 590 (0.8%) of these patients received treatment for OHCA. NoC, sensitivity=77.6% (95% CI 74.1 to 80.8); specificity=86.9% (95% CI 86.6 to 87.1). NHSP, sensitivity=79.2% (95% CI 75.7 to 82.2); specificity=93.4% (93.2 to 93.6). NoC and NHSP combined, sensitivity=84.1% (95% CI 80.9 to 86.8); specificity=95.0% (95% CI 94.8 to 95.3).ConclusionsNoC and subsequent NHSP call categorisation each achieved relatively high sensitivity for the identification of treated OHCA, predicting similar groups of registry patients (although 6% were identified by NoC alone). Overall accuracy was enhanced when NoC and subsequent NHSP Results were combined. The unidentified group of treated OHCA patients (16%) present a challenge to the current dispatch system which relies on the early recognition of patients who may require treatment for OHCA.

scholarly journals PP13 The NHS pathways (NHSP) medical call triage system and new ‘nature of call’ telephone screening tool, employed prior to NHSP, can accurately identify high acuity patients: analysis of sensitivity and specificity using routine ambulance service data

2019 ◽  
Vol 36 (1) ◽  
pp. e5.3-e6
Author(s):  
Jonathan Green ◽  
Sean Ewings ◽  
Richard Wortham ◽  
Bronagh Walsh
Keyword(s):  
Sensitivity And Specificity ◽  
Screening Tool ◽  
High Sensitivity ◽  
Ambulance Service ◽  
Triage System ◽  
Ambulance Dispatch ◽  
Emergency Ambulance ◽  
High Acuity ◽  
Clinical Records ◽  
Service Data

BackgroundThe NHS Pathways (NHSP) medical call triage system is employed by UK ambulance services. One function is to identify a broad category of ‘high-acuity calls’, distinguishing them from those that do not require an emergency response. A new pre-triage screening tool, Nature of Call (NoC), designed to augment NHSP could be employed as a rapid initial sieve of broad acuity.ObjectivesTo identify the accuracy of NHSP (and NoC) in recognising patients who require an emergency ambulance response (and therefore those who may not).MethodsDiagnostic accuracy. The sample is a retrospective cohort of consecutive calls, over a 4 month period, to a UK ambulance service. Sensitivity and specificity were determined, comparing allocated NoC and NHS Pathways priority dispositions with a composite reference standard comprised of administered medications, procedures, observations and clinical impressions associated with high-acuity, as recorded on ambulance electronic Patient Clinical Records.ResultsA total of 1 87 408 emergency calls were received. Of these, 71 373 were allocated both NoC and NHSP priority dispositions and were associated with electronic Patient Clinical Records. 40 997 (57%) of these patients met the high-acuity reference criteria. NHSP, sensitivity=98.1% (95% CI 98.0 to 98.2); specificity=5.9% (95% CI 5.6 to 6.1). NoC, sensitivity=84.0% (95% CI 83.7 to 84.4); specificity=26.5% (95% CI 26.0 to 27.0).ConclusionsNHSP is effective in identifying high-acuity patients (as is NoC). Sensitivity analysis therefore supports the this function of NHSP and NoC/NHSP to inform initial ambulance dispatch decisions, particularly if NoC categorisation is reviewed in the light of subsequent NHSP triage. However, both systems appear to achieve high sensitivity by also allocating most low-acuity calls to high-acuity categories. This significantly restricts operational application. Only one quarter of low-acuity calls are allocated the lowest priority category by NoC and one-in-seventeen by NHSP, severely restricting the group likely to be considered for alternative care pathways.

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