Test characteristics of Raman spectroscopy integrated with polarized light microscopy for the diagnosis of acute gouty arthritis
Authors' conclusion
iRPolM is a promising next-generation diagnostic tool for rheumatology by diagnosing gout with high specificity, increased objectivity, and a sensitivity comparable to PLM.
Study context
- Population
- Consecutive synovial fluid samples from any peripheral swollen joint67 classified as gout
- Participants
- 200 participants
- Comparison
- Integrated with polarized light microscopy (iRPolM) vs 2015 ACR/EULAR gout classification criteria (reference test) and vs polarized light microscopy (PLM) by a rheumatologist
- Outcome
- Diagnostic accuracy of iRPolM for gout vs 2015 ACR/EULAR gout classification criteria
Methodological detailsprospective, consecutive synovial fluid samples, iRPolM analysed after unblinding PLM results
- Prospective
- Consecutive synovial fluid samples
- iRPolM analysed after unblinding PLM results
Performance
As reported in the abstract
Diagnosis of gout vs 2015 ACR/EULAR criteria
| Test or model | Sensitivity | Specificity | PPV | NPV | Accuracy | Positive likelihood ratio | Negative likelihood ratio |
|---|---|---|---|---|---|---|---|
| iRPolM | 77.6% (95% CI: 65.8-86.9) | 97.7% (95% CI: 93.5-99.5) | 94.5% (95% CI: 84.9-98.2) | 89.7% (95% CI: 84.7-93.1) | 91.0% (95% CI: 86.2-94.6) | 34.4 (95% CI: 11.16-106.10) | 0.23 (95% CI: 0.15-0.36) |
iRPolM
Sensitivity77.6% (95% CI: 65.8-86.9)
Specificity97.7% (95% CI: 93.5-99.5)
PPV94.5% (95% CI: 84.9-98.2)
NPV89.7% (95% CI: 84.7-93.1)
Accuracy91.0% (95% CI: 86.2-94.6)
Positive likelihood ratio34.4 (95% CI: 11.16-106.10)
Negative likelihood ratio0.23 (95% CI: 0.15-0.36)
Further findings
| Outcome | iRPolM |
|---|---|
| Identification of MSU in PLM-positive samples (vs PLM; 55 PLM-positive) | |
| Sensitivity | 91.2% (95% CI: 80.7-97.1) |
| Specificity | 97.6% (95% CI: 93.0-99.5) |
| PPV | 94.6% (95% CI: 85.0-98.2) |
| NPV | 96.0% (95% CI: 91.2-98.2) |
| Accuracy | 95.6% (95% CI: 91.4-98.2) |
| Positive likelihood ratio | 37.4 (95% CI: 12.20-114.71) |
| Negative likelihood ratio | 0.09 (95% CI: 0.04-0.21) |
- Identification of MSU in PLM-positive samples (vs PLM; 55 PLM-positive) — Interrater agreement PLM vs iRPolM near perfect (к)
- 0.90
Original publication
Test characteristics of Raman spectroscopy integrated with polarized light microscopy for the diagnosis of acute gouty arthritis. Joint Bone Spine. Published 11 July 2023. doi:10.
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