PMID- 23139266
OWN - NLM
STAT- MEDLINE
DCOM- 20131126
LR  - 20191210
IS  - 1468-2060 (Electronic)
IS  - 0003-4967 (Linking)
VI  - 72
IP  - 10
DP  - 2013 Oct
TI  - ASAS modification of the Berlin algorithm for diagnosing axial spondyloarthritis: 
      results from the SPondyloArthritis Caught Early (SPACE)-cohort and from the 
      Assessment of SpondyloArthritis international Society (ASAS)-cohort.
PG  - 1646-53
LID - 10.1136/annrheumdis-2012-201884 [doi]
AB  - OBJECTIVE: To compare the original Berlin algorithm for diagnosing axial 
      Spondyloarthritis (axSpA) with two modifications in the SPondyloArthritis Caught 
      Early (SPACE)-cohort and the Assessment of SpondyloArthritis international 
      Society (ASAS) axSpA criteria validation (ASAS)-cohort. METHODS: Patients in the 
      SPACE-cohort (back pain >/=3 months, </=2 years, onset <45 years) and the ASAS-cohort 
      (undiagnosed chronic back pain) were diagnosed according to three algorithms: 
      original (inflammatory back pain (IBP) mandatory), modification 1 (IBP defined by 
      >/=3/5 IBP-features instead of >/=4/5) and modification 2 (IBP deleted as obligatory 
      entry criterion, added as SpA-feature). Diagnosis by rheumatologist, ASAS axSpA 
      criteria and likelihood ratio product were used as external standards to test the 
      performance of the algorithms. RESULTS: SPACE-cohort: Compared to the diagnosis 
      by rheumatologist (either axSpA or no-axSpA), the original algorithm agreed in 
      120 patients (76.4%). Agreement decreased using modification 1 (119 patients; 
      75.8%), increased using modification 2 (125 patients; 79.6%). Sensitivity 
      increased from 66.2% (original) to 72.3% (modification 1) and 78.5% (modification 
      2). Specificity decreased more using modification 1 (83.7% to 78.3%) than when 
      using modification 2 (83.7% to 79.6%). ASAS-cohort: Compared to the diagnosis by 
      rheumatologist (either axSpA or no-axSpA), the original algorithm agreed in 484 
      patients (70.7%). Agreement increased using modification 1 (520 patients; 75.9%) 
      and modification 2 (548 patients; 80.0%). Sensitivity increased from 65.3% 
      (original) to 77.9% (modification 1) and 79.6% (modification 2). Specificity 
      decreased more using modification 1 (79.2% to 72.2%) than when using modification 
      2 (79.2% to 75.6%). CONCLUSIONS: ASAS accepted a modified algorithm for 
      diagnosing axSpA in which IBP is excluded as obligatory entry criterion and added 
      as SpA-feature.
FAU - van den Berg, Rosaline
AU  - van den Berg R
AD  - Department of Rheumatology, Leiden University Medical Center, Leiden, the 
      Netherlands.
FAU - de Hooge, Manouk
AU  - de Hooge M
FAU - Rudwaleit, Martin
AU  - Rudwaleit M
FAU - Sieper, Joachim
AU  - Sieper J
FAU - van Gaalen, Floris
AU  - van Gaalen F
FAU - Reijnierse, Monique
AU  - Reijnierse M
FAU - Landewe, Robert
AU  - Landewe R
FAU - Huizinga, Tom
AU  - Huizinga T
FAU - van der Heijde, Desiree
AU  - van der Heijde D
LA  - eng
PT  - Comparative Study
PT  - Evaluation Study
PT  - Journal Article
DEP - 20121108
PL  - England
TA  - Ann Rheum Dis
JT  - Annals of the rheumatic diseases
JID - 0372355
RN  - 0 (HLA-B27 Antigen)
SB  - IM
MH  - Adult
MH  - *Algorithms
MH  - Back Pain/etiology
MH  - Chronic Pain/etiology
MH  - Cohort Studies
MH  - Decision Support Techniques
MH  - Decision Trees
MH  - Diagnostic Errors
MH  - Female
MH  - HLA-B27 Antigen/blood
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Sensitivity and Specificity
MH  - Spondylarthritis/complications/*diagnosis
MH  - Young Adult
OTO - NOTNLM
OT  - Ankylosing Spondylitis
OT  - Magnetic Resonance Imaging
OT  - Spondyloarthritis
EDAT- 2012/11/10 06:00
MHDA- 2013/12/16 06:00
CRDT- 2012/11/10 06:00
PHST- 2012/11/10 06:00 [entrez]
PHST- 2012/11/10 06:00 [pubmed]
PHST- 2013/12/16 06:00 [medline]
AID - annrheumdis-2012-201884 [pii]
AID - 10.1136/annrheumdis-2012-201884 [doi]
PST - ppublish
SO  - Ann Rheum Dis. 2013 Oct;72(10):1646-53. doi: 10.1136/annrheumdis-2012-201884. 
      Epub 2012 Nov 8.