Performance of a triage approach for identification of patients with inflammatory rheumatic and musculoskeletal diseases among rheumatology referrals
Authors' conclusion
The triage approach accelerated assessment for more than two-thirds of patients with iRMD, while highlighting the necessity of a full workup to capture the one-third of cases otherwise missed.
Study context
- Population
- Consecutive referrals to a tertiary rheumatology centre980 proceeded to final assessment
- Participants
- 1,180 participants
- Comparison
- Triage approach vs final comprehensive assessment
- Outcome
- Diagnostic performance of triage for identifying iRMD, and wait times
Methodological detailsprospective, consecutive referrals, tertiary centre, retrospective machine learning (ML) models, inflammatory rheumatic and musculoskeletal disease (iRMD) suspected in 413 (35%), not suspected in 767 (65%); 52 (4.4%) forwent further evaluation, 1128 scheduled for comprehensive assessment; 148 (13.1%) dropped out
- Prospective
- Consecutive referrals
- Tertiary centre
- Retrospective ML models
- iRMD suspected in 413 (35%), not suspected in 767 (65%); 52 (4.4%) forwent further evaluation
- 1128 scheduled for comprehensive assessment; 148 (13.1%) dropped out
Performance
As reported in the abstract
Identification of iRMD (iRMD diagnosed in 314 [32%])
| Test or model | Sensitivity | Specificity | iRMD correctly identified | non-iRMD correctly identified |
|---|---|---|---|---|
| Step 2 | 67.2% | 75.4% | 211 | 502 |
Step 2
Sensitivity67.2%
Specificity75.4%
iRMD correctly identified211
non-iRMD correctly identified502
Further findings
Time from telephone interview to final assessment
AUC-ROC
Step 1 ML model
0.73(95% CI: 0.65-0.80)
Step 2 ML model
0.78(95% CI: 0.70-0.86)
- Retrospectively investigated
Time from telephone interview to final assessment
- Shorter for patients with iRMD than without iRMD
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Performance of a triage approach for identification of patients with inflammatory rheumatic and musculoskeletal diseases among rheumatology referrals. Ann Rheum Dis. Published 5 September 2026. doi:10.
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