Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore.
Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Lupus. 2021 Jan;30(1):35-44. doi: 10.1177/0961203320966378. Epub 2020 Oct 22.
Early detection of autoimmune rheumatic diseases is crucial given their high morbidity and mortality and short window of opportunity to improve patient outcomes. Self-administered screening questionnaires such as the connective tissue disease screening questionnaire (CSQ) have been shown to promote early detection of autoimmune rheumatic diseases. However, optimal scoring of screening questionnaires may differ with prevalence of clinical features and changes in classification criteria. We compared the performance of 3 scoring methods for the CSQ for early detection of autoimmune rheumatic diseases in a multi-ethnic Asian population.
Patients who were newly referred for evaluation of possible autoimmune rheumatic diseases were invited to answer the cross-culturally adapted CSQ. Detection of autoimmune rheumatic diseases using 1) the original CSQ scoring, 2) a modified CSQ scoring and 3) a scoring based on current classification criteria, were compared to classification of autoimmune rheumatic diseases by classification criteria.
Of 819 participants, 85 were classified as having autoimmune rheumatic diseases screened for by the adapted CSQ. The original CSQ scoring yielded relatively lower sensitivities in detecting both any and individual autoimmune rheumatic diseases (67% and 20-57%, respectively) compared to the modified CSQ scoring (81% and 60-73%, respectively) and the scoring based on current classification criteria (89% and 50-88%, respectively).
The adapted CSQ with the classification criteria-based scoring achieved relatively high sensitivities in detecting autoimmune rheumatic diseases, suggesting this could be employed as the first step in population screening.
鉴于自身免疫性风湿病的高发病率、高死亡率和改善患者预后的机会窗口很短，因此早期发现此类疾病至关重要。自身抗体筛查问卷（如结缔组织病筛查问卷）已被证明可促进自身免疫性风湿病的早期发现。然而，筛查问卷的最佳评分可能因临床特征的流行情况和分类标准的变化而有所不同。我们比较了 3 种用于 CSQ 的评分方法在多民族亚洲人群中对自身免疫性风湿病早期检测的性能。
邀请新转诊来评估可能患有自身免疫性风湿病的患者回答跨文化适应的 CSQ。使用 1）原始 CSQ 评分、2）改良 CSQ 评分和 3）基于当前分类标准的评分来检测自身免疫性风湿病，并与分类标准对自身免疫性风湿病的分类进行比较。
在 819 名参与者中，有 85 名被归类为经 CSQ 筛查的自身免疫性风湿病患者。与改良 CSQ 评分（分别为 81%和 60-73%）和基于当前分类标准的评分（分别为 89%和 50-88%）相比，原始 CSQ 评分在检测任何自身免疫性风湿病和个别自身免疫性风湿病方面的敏感性相对较低（分别为 67%和 20-57%）。
基于分类标准的适应性 CSQ 评分具有较高的自身免疫性风湿病检测敏感性，提示该评分可作为人群筛查的第一步。
