BackgroundACR/EULAR 2016 classification criteria for Sjögren disease (SS) 1 use 5 standard questions on ocular and oral sicca symptoms as an entrance criteria. However, these questions do not differentiate between SS and non-SS sicca etiology. Recently, a new 5-item Sjögren’s Syndrome Screening Questionnaire based on SICCA study data was designed for the use in clinical practice, better differentiating SS from non-SS sicca patienents.2ObjectivesWe aimed to validate the SSSQ in our population with sicca symptoms.MethodsOur study cohort represented 535 patients referred to UMC Ljubljana during the 3-year period Jan/2016 to Dec/2019 with suspected SS. All subjects underwent at that time a standardized SS diagnostic procedure, including 5 standard sicca questions, Schirmer test, Rose Bengal test, unstimulated salivary flow test, salivary gland ultrasound, immunoserological and lip biopsy. In Sep - Oct 2021 all subjects were contacted by phone to fulfil the new SSSQ (5 questions resulting in 0-11 points: cut-off for SS ≥7 points). The performance of SSSQ recognizing SS was assessed using ACR/EULAR 2016 classification criteria as gold standard test for SS diagnosis.Results415 out of 525 subjects agreed to participate in the study (384 (92.5%) females, mean (SD) age 57.6(13.8)), the rests either declined (21), died (2) or could not be reached (97). Based on the ACR/EULAR 2016 criteria SS was diagnosed in 127 (30.6%) and excluded in 288 subjects. 376/415 (90.6%) subjects responded positively on 5 standard sicca questions (110 with and 266 without SS). In the new SSSQ 129 (31.1%) subjects (54 with and 75 without SS) responded positively (reached ≥7 points). The performance of SSSQ recognizing SS is presented in Table 1.Table 1.Diagnostic accuracy of SSSQ (Sjögren’s Syndrome Screening Questionnaire) and ACR/EULAR 2016 sicca questions in our cohort. PLR Positive Likelihood Ratio; NLR Negative Likelihood Ratio; PPV Positive Predictive Value; NPV Negative Predictive Value;StatisticsSSSQStandard sicca questionairreValue (95% CI)Value (95%CI)Sensitivity42.5% (33.8 to 51.6%)86.6% (79.4 to 92.0%)Specificity73.7% (68.5 to 78.9%)7.6% (4.9 to 11.3%)PLR1.4 (1.2 to 2.2)0.9 (0.9 to 1.0)NLR0.8 (0.7 to 0.9)1.8 (1.0 to 3.2)PPV41.9% (35.2 to 48.8%)29.3% (27.7 to 30.9%)NPV74.5% (71.2 to 77.5%)56.4% (41.6 to 70.2%)Accuracy64.3% (59.5 to 69.0%)31.8% (27.4 to 36.5%)AUC0.58 (0.52-0.64)0.52 (0.46-0.57)ConclusionSSSQ showed higher specificity and better diagnostic accuracy compared to current standard questionnaire in a cohort of sicca patients.References[1]Shiboski CH, et al. Arthritis Rheumatol. 2017;69:35–45.[2]Yu K, et al. J Clin Rheumatol 2021; doi: 10.1097/RHU.0000000000001760AcknowledgementsThis work was supported by Slovenian National Research Agency grants P3-0314 and J3-3153.Disclosure of InterestsNone declared
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