A comparison of the performance characteristics of classification criteria for the diagnosis of psoriatic arthritis
Section snippets
Materials and methods
Patients with RA or PsA were identified from clinical databases at St. Luke’s Hospital, Bradford, United Kingdom, and G. Pini Orthopaedic Institute, Milan, Italy. All available radiographs and case notes were reviewed and data items were extracted to enable classification by each method. Radiographic features were defined using the definitions developed by an earlier observer reliability study (7). Data were recorded onto standardized forms and included demographics (ethnicity, gender, age),
Results
There were 499 patients identified from the clinical database (343 with PsA, 156 with RA). The disease duration was similar between each disease group, but patients with PsA were younger and more likely to be male (Table 2).
The discriminant value of laboratory and clinical features (Table 3) and radiologic features (Table 4) are expressed in terms of sensitivity and specificity. Sensitivity refers to the proportion of patients with PsA who have the feature, and specificity refers to the
Discussion
There have been few reported studies that compare different diagnostic criteria for the diagnosis of PsA (20). We found that among patients with PsA and RA, the currently proposed classification criteria have nearly equivalent test performance, apart from the Bennett criteria and ESSG criteria that are significantly less sensitive. As a rough index of feasibility, the proportion of subjects unable to be classified because of missing data items was similar for each rule except for Fournie. Using
Acknowledgments
We gratefully acknowledge John Horwood of the Christchurch School of Medicine, New Zealand, for assistance with the statistical analysis.
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From the Rheumatology and Rehabilitation Research Unit, University of Leeds, Leeds, United Kingdom; U.O. Di Reumatologia, Istituto Ortopedico G. Pini, Milano, Italy; and the Department of Rheumatology, St. Lukes Hospital, Bradford, United Kingdom.
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Dr. Taylor was the recipient of the Dorothy Eden Fellowship of the Arthritis Foundation of New Zealand and the Arthritis Research Campaign during this study (Grant Number T0520).