High sensitivity, specificity and predictive value of the Connective Tissue                 Disease Screening Questionnaire among urban African-American women

Objective Further prospective study is needed to elucidate the etiology and natural history of systemic lupus erythematosus development. The clinical complexity of this heterogeneous disease makes study design challenging. Our objective was to ascertain useful screening factors for identifying at-risk individuals for follow-up rheumatologic assessment or inclusion in prospective studies. Methods We attempted to re-contact 3823 subjects with a family history of systemic lupus erythematosus, who did not meet American College of Rheumatology systemic lupus erythematosus classification at a baseline study visit; 436 agreed to follow-up participation an average of 6.3 years after baseline. In total, 56 of these individuals had transitioned to classified systemic lupus erythematosus (≥ 4 cumulative American College of Rheumatology criteria, verified by medical record review) by the time of follow up. Generalized estimating equations assessed associations between our dichotomous outcome of transitioning to systemic lupus erythematosus with baseline characteristics, including ANA positivity, Connective Tissue Disease Screening questionnaire systemic lupus erythematosus score, and number of American College of Rheumatology criteria. We analyzed predictive accuracy of characteristics on transitioning. Results ANA positivity, Connective Tissue Disease Screening questionnaire systemic lupus erythematosus score categorization of possible or probable systemic lupus erythematosus, and greater number of American College of Rheumatology criteria at baseline were each associated with transitioning to systemic lupus erythematosus classification. Being ANA positive and having confirmed immunologic criteria at baseline had the highest positive predictive value and specificity for transitioning to systemic lupus erythematosus. American College of Rheumatology Connective Tissue Disease Screening questionnaire systemic lupus erythematosus score categorization of possible or probable systemic lupus erythematosus had a better positive predictive value, negative predictive value, sensitivity, and specificity than ANA positivity. Conclusion Given limited resources, identifying individuals for follow up based on the systemic lupus erythematosus portion of the Connective Tissue Disease Screening questionnaire could be an efficient way to identify family members at highest risk of disease transition.

Download Full-text

Lung Ultrasound in the Screening of Pulmonary Interstitial Involvement Secondary to Systemic Connective Tissue Disease: A Prospective Pilot Study Involving 180 Patients

Journal of Clinical Medicine ◽

10.3390/jcm10184114 ◽

2021 ◽

Vol 10 (18) ◽

pp. 4114

Author(s):

Natalia Buda ◽

Anna Wojteczek ◽

Anna Masiak ◽

Maciej Piskunowicz ◽

Wojciech Batko ◽

...

Keyword(s):

Connective Tissue ◽

Connective Tissue Disease ◽

Sensitivity And Specificity ◽

Predictive Value ◽

Lung Ultrasound ◽

Imaging Modality ◽

Connective Tissue Diseases ◽

High Sensitivity ◽

Study Group ◽

A Prospective Study

Objectives: The aim of the study was the assessment of lung ultrasound (LUS) as a screening of pulmonary interstitial involvement secondary to systemic connective tissue diseases. Methods: A prospective study was conducted on the study group comprising 180 patients diagnosed with different systemic connective tissue diseases. Each patient underwent lung ultrasound (LUS), high-resolution chest computed tomography (HRCT), and echocardiography (ECHO). Each imaging examination was blinded and performed by an independent operator. LUS was conducted with convex and linear transducers. Results: The sensitivity and specificity of LUS as compared to HRCT in detecting pulmonary interstitial involvement in the study group were 99.3% and 96.4%, respectively; positive predictive value (PPV) 0.7, negative predictive value (NPV) 3.6. Abnormalities indicating interstitial lung disease (ILD) with fibrosis were most frequently localized bilaterally in the lower fields of the lungs, assessed in the dorsal view. Conclusions: LUS is an efficient imaging modality that can detect pulmonary interstitial involvement in patients with systemic connective tissue disease with a high sensitivity and specificity. Further prospective studies conducted on a larger population are deemed necessary.

Download Full-text

A connective tissue disease screening questionnaire for population studies

Annals of Epidemiology ◽

10.1016/1047-2797(94)00096-c ◽

1995 ◽

Vol 5 (4) ◽

pp. 297-302 ◽

Cited By ~ 143

Author(s):

Elizabeth W. Karlson ◽

Jorge Sanchez-Guerrero ◽

Elizabeth A. Wright ◽

Robert A. Lew ◽

Lawren H. Daltroy ◽

...

Keyword(s):

Connective Tissue ◽

Connective Tissue Disease ◽

Population Studies ◽

Disease Screening ◽

Screening Questionnaire

Download Full-text

Prevalence of systemic lupus erythematosus-related symptoms assessed by using the Connective Tissue Disease Screening Questionnaire in a large population-based cohort

Lupus Science & Medicine ◽

10.1136/lupus-2021-000555 ◽

2021 ◽

Vol 8 (1) ◽

pp. e000555

Author(s):

Wietske Lambers ◽

Suzanne Arends ◽

Caroline Roozendaal ◽

Elisabeth Brouwer ◽

Hendrika Bootsma ◽

...

Keyword(s):

Connective Tissue ◽

Connective Tissue Disease ◽

Lupus Erythematosus ◽

Early Stage ◽

Large Population ◽

Population Based ◽

Disease Screening ◽

Screening Questionnaire ◽

American College Of Rheumatology ◽

Starting Point

BackgroundTo assess the prevalence of self-reported SLE-related symptoms associated with demographic and biochemical data and connective tissue disease (CTD)-related autoantibodies in a large population-based cohort.MethodsParticipants of the Dutch Lifelines population cohort filled out the Connective Tissue Disease Screening Questionnaire (CSQ), including 11 questions focusing on SLE-related symptoms (SLE-CSQ) based on the American College of Rheumatology classification criteria. CTD autoantibody screen was performed in 25% of participants.ResultsOf 85 295 participants with complete SLE-CSQ data, after excluding patients with SLE and other CTDs (n=126), 41 781 (49.1%) had no positively answered questions and 2210 (2.6% of total) had ≥4 positive answers. Participants with ≥4 answers on the SLE-CSQ were significantly younger, more frequently female, had lower body mass index (BMI) and were more often smokers than those with negative scores. Furthermore, counts of leucocytes, neutrophils and monocytes were significantly higher in these participants, while the levels of haemoglobin and creatinine were lower. CTD autoantibodies were present in 2.2% of participants with SLE-CSQ score of 0, compared with 3.5% with SLE-CSQ score ≥4 (p=0.001). Multivariate analysis showed, after adjusting for age, gender, BMI and smoking, that haemoglobin levels remained significantly lower in participants with SLE-CSQ score ≥4.ConclusionsIn this large population-based cohort, 2.6% of participants without diagnosed CTD reported ≥4 positive answers on the SLE-CSQ, indicating high suspicion for SLE. These individuals had demographic and haematological characteristics that differed from the remaining population. Potentially, this questionnaire, in combination with autoantibody determination, can be used as a starting point of a screening cascade in order to detect SLE at an early stage.

Download Full-text