Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Golgasht St, P.O Box 5166614756, Tabriz, Iran.
Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Clin Rheumatol. 2024 Jul;43(7):2337-2342. doi: 10.1007/s10067-024-07010-6. Epub 2024 May 22.
Four criteria have been proposed for the diagnosis of palindromic rheumatism (PR), including those of Hannonen et al., Passero and Barbieri, Guerne and Weisman, and Gonzalez-López. But none of these criteria has been validated. In this research, we investigated the performance of these diagnostic criteria for diagnosing PR.
In this study, PR and control groups were consecutively recruited from a prospective cohort of intermittent arthritis. Inclusion criteria for PR group were diagnosing PR by an expert rheumatologist, age ≥ 18, having at least 6 months follow-up, and ruling out of other causes of intermittent arthritis. These criteria were applied to both groups. Sensitivity, specificity, positive predictive value, negative predictive value, diagnostic odds ratio (DOR), and Youden's index were calculated for each criteria.
This study included 197 consecutive subjects diagnosed with PR and 208 subjects with a diagnosis other than PR. The sensitivity of Hannonen et al. criteria was higher than the Gonzalez-Lopez, Guerne and Weisman, and Pasero and Barbieri criteria (96.4% versus 95.4%, 79.2%, and 35.5%, respectively). The specificity of the Pasero and Barbieri criteria was higher than the other criteria. Hannonen al. criteria with a DOR of 325.7, had the highest DOR. In descending order, the best accuracy belonged to Hannonen et al., Gonzalez-Lopez, Guerne and Weisman, and Pasero and Barbieri criteria (94.3%, 94.1%, 86.4%, and 66.9% respectively).
This study showed that the Hannonen et al. and Gonzalez-Lopez criteria have a better performance in diagnosing PR. Key Points • The sensitivity of Hannonen et al. criteria and the specifity of Passero and Barbieri criteria are higher than other proposed criteria for diagnosis of palindromic rheumatism. • Hannonen et al. criteria with a sensitivity of 96.4%, specifity of 92.3% and accuracy of 94.3% has the best performance in diagnosis of palindromic rheumatism between existing diagnostic criteria for palindromic rheumatism.
已经提出了四项用于诊断回旋性风湿症（PR）的标准，包括 Hannonen 等人、Passero 和 Barbieri、Guerne 和 Weisman 以及 Gonzalez-López 的标准。但这些标准都没有经过验证。在这项研究中，我们研究了这些诊断标准对诊断 PR 的表现。
在这项研究中，PR 组和对照组连续从间歇性关节炎的前瞻性队列中招募。PR 组的纳入标准为专家风湿病学家诊断为 PR、年龄≥18 岁、至少有 6 个月的随访、排除其他原因引起的间歇性关节炎。这些标准适用于两组。为每个标准计算了敏感性、特异性、阳性预测值、阴性预测值、诊断比值比（DOR）和 Youden 指数。
这项研究包括 197 名连续诊断为 PR 的患者和 208 名诊断为 PR 以外疾病的患者。Hannonen 等人标准的敏感性高于 Gonzalez-Lopez、Guerne 和 Weisman 以及 Pasero 和 Barbieri 标准（分别为 96.4%、95.4%、79.2%和 35.5%）。Pasero 和 Barbieri 标准的特异性高于其他标准。具有 325.7 DOR 的 Hannonen al. 标准具有最高的 DOR。准确性依次为 Hannonen 等人、Gonzalez-Lopez、Guerne 和 Weisman 和 Pasero 和 Barbieri 标准（分别为 94.3%、94.1%、86.4%和 66.9%）。
这项研究表明，Hannonen 等人和 Gonzalez-Lopez 标准在诊断 PR 方面表现更好。关键点：• Hannonen 等人标准的敏感性和 Passero 和 Barbieri 标准的特异性高于其他回旋性风湿症诊断标准。• 在现有的回旋性风湿症诊断标准中，Hannonen 等人标准的敏感性为 96.4%、特异性为 92.3%、准确性为 94.3%，在诊断回旋性风湿症方面表现最好。
