Spondyloarthritis & psoriatic arthritis
What is the best referral strategy for axial spondyloarthritis? A prospective multicenter study in patients with suspicious chronic low back pain
Authors' conclusion
Optimizing physicians' awareness of these clinical features may enhance referral in axSpA.
Study context
- Population
- Consecutive adults aged under 45 years with low back pain (LBP) suspicious of inflammatory nature per first-line physician, LBP first-line clinics, Middle Eastern Arab countries
- Participants
- 515 referred patients
- Comparison
- Ten referral strategies for axial spondyloarthritis (axSpA) and inflammatory back pain (IBP) vs rheumatologist's final diagnosis (gold standard)
- Outcome
- Diagnostic properties of referral strategies for axSpA
Methodological detailsprospective, multicentre, multivariable logistic regression
- Prospective
- Multicentre
- Multivariable logistic regression
Performance
As reported in the abstract
Diagnostic properties of referral strategies (PLR)
| Test or model | PLR |
|---|---|
| MASTER | 3.3 |
| RADAR 2/3 | 2.9 |
PLR
MASTER3.3
RADAR 2/32.9
Further findings
Final diagnosis
- axSpA confirmed
- 48%
- axSpA refuted
- 43%
- Diagnosis inconclusive
- 9%
Predictive factors for axSpA (multivariable logistic regression)
- MRI sacroiliitis, positive HLA-B27, high CRP, psoriasis, IBP, and longer symptom duration
Referral source
- Self-referred
- 35%
- Primary care physicians
- 16%
- Neuro/orthopedic surgeons
- 15%
Original publication
What is the best referral strategy for axial spondyloarthritis? A prospective multicenter study in patients with suspicious chronic low back pain. Joint Bone Spine. Published 18 April 2023. doi:10.
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