Department of Gastroenterology, Infectious Diseases and Rheumatology, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin.
Department of Epidemiology, German Rheumatism Research Centre, Berlin, Germany.
Rheumatology (Oxford). 2020 Oct 1;59(Suppl4):iv6-iv17. doi: 10.1093/rheumatology/keaa250.
In recent years, significant progress has been made in improving the early diagnosis of spondyloarthritides (SpA), including axial SpA. Nonetheless, there are still issues related to the application of classification criteria for making the primary diagnosis of SpA in the daily practice. There are substantial conceptional and operational differences between the diagnostic vs classification approach. Although it is not possible to develop true diagnostic criteria for natural reasons as discussed in this review, the main principles of the diagnostic approach can be clearly defined: consider the pre-test probability of the disease, evaluate positive and negative results of the diagnostic test, exclude other entities, and estimate the probability of the disease at the end. Classification criteria should only be applied to patients with an established diagnosis and aimed at the identification of a rather homogeneous group of patients for the conduction of clinical research.
近年来，在提高脊柱关节炎（SpA），包括中轴型 SpA 的早期诊断方面取得了重大进展。尽管如此，在日常实践中应用 SpA 的分类标准进行主要诊断仍存在一些问题。诊断方法与分类方法之间存在实质性的概念和操作差异。正如本综述中所讨论的，由于自然原因，不可能开发出真正的诊断标准，但可以明确界定诊断方法的主要原则：考虑疾病的术前概率，评估诊断测试的阳性和阴性结果，排除其他实体，并在最后估计疾病的概率。分类标准仅应用于已确诊的患者，旨在识别具有相对同质患者群体的患者，以进行临床研究。
