Department of Rheumatology & Immunology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Front Immunol. 2021 Dec 3;12:733708. doi: 10.3389/fimmu.2021.733708. eCollection 2021.
High prevalence of undiagnosed psoriatic arthritis (PsA) and prolonged diagnostic delay are key troubles in the appropriate management of PsA. To analyze the possible causes for this phenomenon, a web-based nationwide survey was conducted to investigate rheumatologists' perceptions on PsA diagnosis in China.
The electronic questionnaire consisting of 38 questions were designed by an expert panel and distributed with the online survey tool Sojump, which is a professional online survey platform. The completed questionnaires by real-name rheumatologists were collected.
A total of 1594 valid questionnaires were included. More than half of Chinese rheumatologists reported it was challenging to make a diagnosis of PsA. The four major challenges were "Difficulties in identification of atypical or hidden psoriasis", "Absence of diagnostic biomarkers", "No active self-report of history or family history of psoriasis" and "Various musculoskeletal manifestations". In diagnosing PsA, minor participants had incorrect knowledge of inflammatory arthropathy (13.7%), acute phase reactant (23.8%), and rheumatoid factor (28.7%). There were no significant differences in the knowledge of PsA and practice habits in diagnosing PsA between modern western medicine (WM)- and traditional Chinese medicine (TCM)-rheumatologists. The part-time rheumatologists were not as good as full-time rheumatologists in diagnosing PsA.
About three quarters of Chinese rheumatologists are familiar with the elements in PsA diagnosis and have good practice habits in diagnosing PsA. Four main challenges in making PsA diagnosis are revealed. There was no significant difference in the knowledge of PsA between WM- and TCM-rheumatologists.
银屑病关节炎（PsA）的高患病率和诊断延迟时间长是影响 PsA 合理管理的关键问题。为分析这一现象的可能原因，我们开展了一项基于网络的全国性调查，以调查中国风湿病医师对 PsA 诊断的看法。
由专家小组设计了包含 38 个问题的电子问卷，并使用在线调查工具 Sojump 进行了分发，Sojump 是一个专业的在线调查平台。收集真实姓名的风湿病医师填写的完整问卷。
共纳入 1594 份有效问卷。超过一半的中国风湿病医师报告称，PsA 的诊断具有挑战性。四大挑战为“识别不典型或隐匿性银屑病有困难”、“缺乏诊断生物标志物”、“无主动报告银屑病病史或家族史”和“各种肌肉骨骼表现”。在诊断 PsA 时，小部分参与者对炎症性关节炎（13.7%）、急性期反应物（23.8%）和类风湿因子（28.7%）存在错误认识。在诊断 PsA 方面，现代西医（WM）和中医（TCM）风湿病医师之间在 PsA 知识和诊断实践习惯方面没有显著差异。兼职风湿病医师在诊断 PsA 方面不如全职风湿病医师。
约四分之三的中国风湿病医师熟悉 PsA 诊断要素，且具有良好的 PsA 诊断实践习惯。揭示了诊断 PsA 时的 4 大主要挑战。WM 和 TCM 风湿病医师在 PsA 知识方面无显著差异。
