Performances of the ASAS axial spondyloarthritis criteria for diagnostic and classification purposes in patients visiting a rheumatologist because of chronic back pain: The DECLIC study.

Arthritis care & research

PubMedID: 23554182

Moltó A, Paternotte S, Comet D, Thibout E, Rudwaleit M, Claudepierre P, van der Heijde D, Dougados M. Performances of the ASAS axial spondyloarthritis criteria for diagnostic and classification purposes in patients visiting a rheumatologist because of chronic back pain: The DECLIC study. Arthritis Care Res (Hoboken). 2013;.
OBJECTIVES: To evaluate the performances (sensitivity, specificity, positive and negative predictive values) at diagnosis and study visit of the ASAS criteria in axial spondyloarthritis in patients with for chronic back pain (CBP). Secondary objective: identifying the most contributory item to diagnosis/classify spondyloarthritis. METHODS: Multi-centre, cross-sectional study. Patients: history of CBP under 45years visiting a rheumatologist in France. Data: a) items of the different sets of criteria, checking if present at diagnosis ('diagnosis')/after diagnosis but at study visit ('classification'); b) Rheumatologist diagnosis at study visit. Statistical analysis: descriptive characteristics and performances for diagnosis and classification. The diagnosis of the rheumatologist was considered as the "gold standard". RESULTS: 1210 patients were eligible for our analysis. Sensitivity and Specificity for ASAS axial criteria were 0.76 and 0.94, and 0.87 and 0.92 for diagnostic and classification purposes, respectively. LR+ of the ASAS axial criteria was 13.6 and 10.30 for diagnostic and classification purposes, respectively. The most contributory items to diagnosis and classification were X-ray sacroiliitis, followed by MRI sacroiliitis for diagnosis and history of uveitis for classification. CONCLUSION: we confirm the validity of the ASAS criteria for both diagnostic and classification purposes, in a clinical setting of patients with CBP. © 2013 by the American College of Rheumatology.