Predictive validity of the ASAS classification criteria for axial and peripheral spondyloarthritis after follow-up in the ASAS cohort: a final analysis

Alexandre Sepriano, Robert Landewé, Désirée van der Heijde, Joachim Sieper, Nurullah Akkoc, Jan Brandt, Jürgen Braun, Eduardo Collantes-Estevez, Maxime Dougados, Oliver Fitzgerald, Feng Huang, Jieruo Gu, Yesim Kirazli, Walter P Maksymowych, Helena Marzo-Ortega, Ignazio Olivieri, Salih Ozgocmen, Euthalia Roussou, Salvatore Scarpato, Inge J Sørensen & 7 others Rafael Valle-Oñate, Filip Van den Bosch, Irene van der Horst-Bruinsma, Ulrich Weber, James Wei, Martin Rudwaleit, ASAS

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

OBJECTIVE: To establish the predictive validity of the Assessment of SpondyloArthritis international Society (ASAS) spondyloarthritis (SpA) classification criteria.

METHODS: 22 centres (N=909 patients) from the initial 29 ASAS centres (N=975) participated in the ASAS-cohort follow-up study. Patients had either chronic (>3 months) back pain of unknown origin and age of onset below 45 years (N=658) or peripheral arthritis and/or enthesitis and/or dactylitis (N=251). At follow-up, information was obtained at a clinic visit or by telephone. The positive predictive value (PPV) of the baseline classification by the ASAS criteria was calculated using rheumatologist's diagnosis at follow-up as external standard.

RESULTS: In total, 564 patients were assessed at follow-up (345 visits; 219 telephone) with a mean follow-up of 4.4 years (range: 1.9; 6.8) and 70.2% received a SpA diagnosis by the rheumatologist. 335 patients fulfilled the axial SpA (axSpA) or peripheral SpA (pSpA) criteria at baseline and of these, 309 were diagnosed SpA after follow-up (PPV SpA criteria: 92.2%). The PPV of the axSpA and pSpA criteria was 93.3% and 89.5%, respectively. The PPV for the 'clinical arm only' was 88.0% and for the 'clinical arm'±'imaging arm' 96.0%, for the 'imaging arm only' 86.2% and for the 'imaging arm'+/-'clinical arm' 94.7%. A series of sensitivity analyses yielded similar results (range: 85.1-98.2%).

CONCLUSIONS: The PPV of the axSpA and pSpA criteria to forecast an expert's diagnosis of 'SpA' after more than 4 years is excellent. The 'imaging arm' and 'clinical arm' of the axSpA criteria have similar predictive validity and are truly complementary.

Original languageEnglish
Pages (from-to)1034-42
Number of pages9
JournalAnnals of the Rheumatic Diseases
Volume75
Issue number6
DOIs
Publication statusPublished - Jun 2016

Cite this

Sepriano, Alexandre ; Landewé, Robert ; van der Heijde, Désirée ; Sieper, Joachim ; Akkoc, Nurullah ; Brandt, Jan ; Braun, Jürgen ; Collantes-Estevez, Eduardo ; Dougados, Maxime ; Fitzgerald, Oliver ; Huang, Feng ; Gu, Jieruo ; Kirazli, Yesim ; Maksymowych, Walter P ; Marzo-Ortega, Helena ; Olivieri, Ignazio ; Ozgocmen, Salih ; Roussou, Euthalia ; Scarpato, Salvatore ; Sørensen, Inge J ; Valle-Oñate, Rafael ; Van den Bosch, Filip ; van der Horst-Bruinsma, Irene ; Weber, Ulrich ; Wei, James ; Rudwaleit, Martin ; ASAS. / Predictive validity of the ASAS classification criteria for axial and peripheral spondyloarthritis after follow-up in the ASAS cohort : a final analysis. In: Annals of the Rheumatic Diseases. 2016 ; Vol. 75, No. 6. pp. 1034-42.
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title = "Predictive validity of the ASAS classification criteria for axial and peripheral spondyloarthritis after follow-up in the ASAS cohort: a final analysis",
abstract = "OBJECTIVE: To establish the predictive validity of the Assessment of SpondyloArthritis international Society (ASAS) spondyloarthritis (SpA) classification criteria.METHODS: 22 centres (N=909 patients) from the initial 29 ASAS centres (N=975) participated in the ASAS-cohort follow-up study. Patients had either chronic (>3 months) back pain of unknown origin and age of onset below 45 years (N=658) or peripheral arthritis and/or enthesitis and/or dactylitis (N=251). At follow-up, information was obtained at a clinic visit or by telephone. The positive predictive value (PPV) of the baseline classification by the ASAS criteria was calculated using rheumatologist's diagnosis at follow-up as external standard.RESULTS: In total, 564 patients were assessed at follow-up (345 visits; 219 telephone) with a mean follow-up of 4.4 years (range: 1.9; 6.8) and 70.2{\%} received a SpA diagnosis by the rheumatologist. 335 patients fulfilled the axial SpA (axSpA) or peripheral SpA (pSpA) criteria at baseline and of these, 309 were diagnosed SpA after follow-up (PPV SpA criteria: 92.2{\%}). The PPV of the axSpA and pSpA criteria was 93.3{\%} and 89.5{\%}, respectively. The PPV for the 'clinical arm only' was 88.0{\%} and for the 'clinical arm'±'imaging arm' 96.0{\%}, for the 'imaging arm only' 86.2{\%} and for the 'imaging arm'+/-'clinical arm' 94.7{\%}. A series of sensitivity analyses yielded similar results (range: 85.1-98.2{\%}).CONCLUSIONS: The PPV of the axSpA and pSpA criteria to forecast an expert's diagnosis of 'SpA' after more than 4 years is excellent. The 'imaging arm' and 'clinical arm' of the axSpA criteria have similar predictive validity and are truly complementary.",
keywords = "Journal Article",
author = "Alexandre Sepriano and Robert Landew{\'e} and {van der Heijde}, D{\'e}sir{\'e}e and Joachim Sieper and Nurullah Akkoc and Jan Brandt and J{\"u}rgen Braun and Eduardo Collantes-Estevez and Maxime Dougados and Oliver Fitzgerald and Feng Huang and Jieruo Gu and Yesim Kirazli and Maksymowych, {Walter P} and Helena Marzo-Ortega and Ignazio Olivieri and Salih Ozgocmen and Euthalia Roussou and Salvatore Scarpato and S{\o}rensen, {Inge J} and Rafael Valle-O{\~n}ate and {Van den Bosch}, Filip and {van der Horst-Bruinsma}, Irene and Ulrich Weber and James Wei and Martin Rudwaleit and ASAS",
note = "Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/",
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Sepriano, A, Landewé, R, van der Heijde, D, Sieper, J, Akkoc, N, Brandt, J, Braun, J, Collantes-Estevez, E, Dougados, M, Fitzgerald, O, Huang, F, Gu, J, Kirazli, Y, Maksymowych, WP, Marzo-Ortega, H, Olivieri, I, Ozgocmen, S, Roussou, E, Scarpato, S, Sørensen, IJ, Valle-Oñate, R, Van den Bosch, F, van der Horst-Bruinsma, I, Weber, U, Wei, J, Rudwaleit, M & ASAS 2016, 'Predictive validity of the ASAS classification criteria for axial and peripheral spondyloarthritis after follow-up in the ASAS cohort: a final analysis' Annals of the Rheumatic Diseases, vol. 75, no. 6, pp. 1034-42. https://doi.org/10.1136/annrheumdis-2015-208730

Predictive validity of the ASAS classification criteria for axial and peripheral spondyloarthritis after follow-up in the ASAS cohort : a final analysis. / Sepriano, Alexandre; Landewé, Robert; van der Heijde, Désirée; Sieper, Joachim; Akkoc, Nurullah; Brandt, Jan; Braun, Jürgen; Collantes-Estevez, Eduardo; Dougados, Maxime; Fitzgerald, Oliver; Huang, Feng; Gu, Jieruo; Kirazli, Yesim; Maksymowych, Walter P; Marzo-Ortega, Helena; Olivieri, Ignazio; Ozgocmen, Salih; Roussou, Euthalia; Scarpato, Salvatore; Sørensen, Inge J; Valle-Oñate, Rafael; Van den Bosch, Filip; van der Horst-Bruinsma, Irene; Weber, Ulrich; Wei, James; Rudwaleit, Martin; ASAS.

In: Annals of the Rheumatic Diseases, Vol. 75, No. 6, 06.2016, p. 1034-42.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Predictive validity of the ASAS classification criteria for axial and peripheral spondyloarthritis after follow-up in the ASAS cohort

T2 - a final analysis

AU - Sepriano, Alexandre

AU - Landewé, Robert

AU - van der Heijde, Désirée

AU - Sieper, Joachim

AU - Akkoc, Nurullah

AU - Brandt, Jan

AU - Braun, Jürgen

AU - Collantes-Estevez, Eduardo

AU - Dougados, Maxime

AU - Fitzgerald, Oliver

AU - Huang, Feng

AU - Gu, Jieruo

AU - Kirazli, Yesim

AU - Maksymowych, Walter P

AU - Marzo-Ortega, Helena

AU - Olivieri, Ignazio

AU - Ozgocmen, Salih

AU - Roussou, Euthalia

AU - Scarpato, Salvatore

AU - Sørensen, Inge J

AU - Valle-Oñate, Rafael

AU - Van den Bosch, Filip

AU - van der Horst-Bruinsma, Irene

AU - Weber, Ulrich

AU - Wei, James

AU - Rudwaleit, Martin

AU - ASAS

N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

PY - 2016/6

Y1 - 2016/6

N2 - OBJECTIVE: To establish the predictive validity of the Assessment of SpondyloArthritis international Society (ASAS) spondyloarthritis (SpA) classification criteria.METHODS: 22 centres (N=909 patients) from the initial 29 ASAS centres (N=975) participated in the ASAS-cohort follow-up study. Patients had either chronic (>3 months) back pain of unknown origin and age of onset below 45 years (N=658) or peripheral arthritis and/or enthesitis and/or dactylitis (N=251). At follow-up, information was obtained at a clinic visit or by telephone. The positive predictive value (PPV) of the baseline classification by the ASAS criteria was calculated using rheumatologist's diagnosis at follow-up as external standard.RESULTS: In total, 564 patients were assessed at follow-up (345 visits; 219 telephone) with a mean follow-up of 4.4 years (range: 1.9; 6.8) and 70.2% received a SpA diagnosis by the rheumatologist. 335 patients fulfilled the axial SpA (axSpA) or peripheral SpA (pSpA) criteria at baseline and of these, 309 were diagnosed SpA after follow-up (PPV SpA criteria: 92.2%). The PPV of the axSpA and pSpA criteria was 93.3% and 89.5%, respectively. The PPV for the 'clinical arm only' was 88.0% and for the 'clinical arm'±'imaging arm' 96.0%, for the 'imaging arm only' 86.2% and for the 'imaging arm'+/-'clinical arm' 94.7%. A series of sensitivity analyses yielded similar results (range: 85.1-98.2%).CONCLUSIONS: The PPV of the axSpA and pSpA criteria to forecast an expert's diagnosis of 'SpA' after more than 4 years is excellent. The 'imaging arm' and 'clinical arm' of the axSpA criteria have similar predictive validity and are truly complementary.

AB - OBJECTIVE: To establish the predictive validity of the Assessment of SpondyloArthritis international Society (ASAS) spondyloarthritis (SpA) classification criteria.METHODS: 22 centres (N=909 patients) from the initial 29 ASAS centres (N=975) participated in the ASAS-cohort follow-up study. Patients had either chronic (>3 months) back pain of unknown origin and age of onset below 45 years (N=658) or peripheral arthritis and/or enthesitis and/or dactylitis (N=251). At follow-up, information was obtained at a clinic visit or by telephone. The positive predictive value (PPV) of the baseline classification by the ASAS criteria was calculated using rheumatologist's diagnosis at follow-up as external standard.RESULTS: In total, 564 patients were assessed at follow-up (345 visits; 219 telephone) with a mean follow-up of 4.4 years (range: 1.9; 6.8) and 70.2% received a SpA diagnosis by the rheumatologist. 335 patients fulfilled the axial SpA (axSpA) or peripheral SpA (pSpA) criteria at baseline and of these, 309 were diagnosed SpA after follow-up (PPV SpA criteria: 92.2%). The PPV of the axSpA and pSpA criteria was 93.3% and 89.5%, respectively. The PPV for the 'clinical arm only' was 88.0% and for the 'clinical arm'±'imaging arm' 96.0%, for the 'imaging arm only' 86.2% and for the 'imaging arm'+/-'clinical arm' 94.7%. A series of sensitivity analyses yielded similar results (range: 85.1-98.2%).CONCLUSIONS: The PPV of the axSpA and pSpA criteria to forecast an expert's diagnosis of 'SpA' after more than 4 years is excellent. The 'imaging arm' and 'clinical arm' of the axSpA criteria have similar predictive validity and are truly complementary.

KW - Journal Article

U2 - 10.1136/annrheumdis-2015-208730

DO - 10.1136/annrheumdis-2015-208730

M3 - Article

VL - 75

SP - 1034

EP - 1042

JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

SN - 0003-4967

IS - 6

ER -