Departments of Rheumatology, Norfolk and Norwich University Hospital, Norwich, Norfolk, United Kingdom NR4 7UY.
Spine (Phila Pa 1976). 2013 Mar 15;38(6):502-6. doi: 10.1097/BRS.0b013e318273aa4f.
Cross-sectional cohort study.
The aim of this study was to develop and validate a patient-completed screening questionnaire for axial spondyloarthropathy for use in the United Kingdom.
Axial spondyloarthropathy (axial SpA) can be difficult to diagnose in the early stages of disease, leading to diagnostic delay and morbidity. Existing population screening tools lack sensitivity or have not been validated in the UK population.
Questionnaires were sent to 295 patients with definite ankylosing spondylitis (meeting modified New York criteria), nonradiographical axial SpA (sacroiliitis on magnetic resonance imaging), or mechanical back pain. Responses from 190 patients were analyzed. Binary logistic regression was used to develop a model differentiating inflammatory from mechanical pain.
The final model (male sex, onset of symptoms by age 33 years, no radiation of pain, pain gets better as day goes on, pain increases with rest, and personal history of iritis) correctly classified 86% of cases with Nagelkerke R = 0.486. A numerical score (with 1 point assigned for each feature present) was calculated and receiver operating characteristic curve was constructed, with area under the curve of 0.911 (95% confidence interval: 0.87-0.96). A score of ≥3/6 had sensitivity of 75.6% and specificity of 87.9% for inflammation.
We have developed a model that differentiates patients with ankylosing spondylitis/axial SpA from those with mechanical spinal disease and can be used as a self-completed screening tool.
横断面队列研究。
本研究旨在开发和验证一种用于英国的轴向脊柱关节炎患者自评筛查问卷。
轴向脊柱关节炎（axial SpA）在疾病早期可能难以诊断，导致诊断延迟和发病。现有的人群筛查工具敏感性不足或未在英国人群中得到验证。
向 295 名明确诊断为强直性脊柱炎（符合改良纽约标准）、非影像学轴向 SpA（磁共振成像骶髂关节炎）或机械性背痛的患者发送了问卷。对 190 名患者的回复进行了分析。采用二项逻辑回归分析来建立一个区分炎症性和机械性疼痛的模型。
最终模型（男性、33 岁前出现症状、疼痛无放射、疼痛随白天好转、疼痛因休息而加剧、个人虹膜炎病史）正确分类了 86%的病例，Nagelkerke R = 0.486。计算了一个数值评分（每个特征存在记 1 分），并构建了受试者工作特征曲线，曲线下面积为 0.911（95%置信区间：0.87-0.96）。评分≥3/6 对炎症的敏感性为 75.6%，特异性为 87.9%。
我们已经开发出一种能够区分强直性脊柱炎/轴向 SpA 患者和机械性脊柱疾病患者的模型，并可作为一种自评筛查工具。
