Richter Jutta G, Wessel Ewa, Klimt Ralf, Willers Reinhardt, Schneider Matthias
Klinik für Endokrinologie, Diabetologie und Rheumatologie, Universitätsklinikum Düsseldorf, Düsseldorf, Germany.
Wien Klin Wochenschr. 2008;120(3-4):103-11. doi: 10.1007/s00508-008-0929-1.
Early diagnosis of inflammatory rheumatic diseases is important for patients' prognosis and outcome. The mean time delay of 1 to 5 years in Germany between the initial symptoms and the first rheumatologist contact should be reduced. Efficiency of patient questionnaires for the identification of inflammatory rheumatic diseases has been demonstrated in other countries. The aim of our study was to develop a patient questionnaire in German identifying inflammatory rheumatic diseases with a high sensitivity and specificity as well as a high positive predictive value.
The RheumaCheck questionnaire was developed by adoption of the FDA-approved Connective Tissue Disease Screening Questionnaire. 1448 patients (195 controls, 437 patients suspicious for and 816 patients with known inflammatory rheumatic diseases) recruited by rheumatologists and general practitioners answered the questionnaire that additionally assessed comorbidities and sociodemographic data. A predictive algorithm was calculated.
Mean age of the complete group (73.1% female) was 52.5 +/- 15.1 years. 53.1% had no comorbidity. Application of the algorithm yields a high sensitivity (77.6%) and specificity (79.9%). The area under the ROC curve was 0.85 (p < 0.0001).
Being aware of a possible high rate of false true results RheumaCheck is a simple, efficient instrument easily filled out by patients. It can identify the group of patients that needs further investigation, care and assessment by a rheumatologist leading to earlier diagnosis and therapy. A web version of RheumaCheck is provided on www.rheuma-check.de .
炎症性风湿性疾病的早期诊断对患者的预后和转归至关重要。德国从出现初始症状到首次接触风湿病专家的平均时间延迟为1至5年，这一情况应得到改善。在其他国家，患者问卷在识别炎症性风湿性疾病方面的有效性已得到证实。我们研究的目的是开发一种德语患者问卷，以高灵敏度、高特异性以及高阳性预测值来识别炎症性风湿性疾病。
通过采用美国食品药品监督管理局（FDA）批准的结缔组织病筛查问卷，开发了风湿检查（RheumaCheck）问卷。由风湿病专家和全科医生招募的1448名患者（195名对照者、437名疑似患者和816名已知患有炎症性风湿性疾病的患者）回答了该问卷，问卷还评估了合并症和社会人口统计学数据。计算了一种预测算法。
整个组的平均年龄为52.5±15.1岁（女性占73.1%）。53.1%的患者无合并症。该算法的应用具有较高的灵敏度（77.6%）和特异性（79.9%）。ROC曲线下面积为0.85（p<0.0001）。
鉴于可能存在较高的假阳性率，风湿检查问卷是一种简单、有效的工具，患者易于填写。它可以识别出需要风湿病专家进一步检查、护理和评估的患者群体，从而实现更早的诊断和治疗。风湿检查问卷的网络版可在www.rheuma-check.de上获取。
