Evaluation of the european spondylarthropathy study group preliminary classification criteria in alaskan eskimo populations

Abstract

Objective. To evaluate the preliminary classification criteria proposed by the European Spondylarthropathy Study Group (ESSG) in Alaskan Eskimo populations.Methods. We examined, interviewed, and reviewed the records of 104 Eskimo patients with spondylarthropathy and 75 with other rheumatic disorders, and evaluated them according to the proposed criteria.Results. We found an overall sensitivity of 88.5% and a specificity of 89.3%, which is similar to the reported values in European populations.Conclusion. The ESSG criteria performed well in a population very different from that in which they were developed, and deserve further evaluation as a muchneeded and useful epidemiologic tool.Epidemiologic studies of the diseases which make up the spondylarthropathies (SpA) have been hampered by the lack of adequate disease criteria (1-4). In earlier studies of rheumatic disease prevalence in native populations of Alaska, we found that (3,4). Recently, the European Spondylarthropathy Study Group (ESSG) developed classification criteria intended to encompass a broader spectrum of spondylarthropathic disease, with the specific intent of including previously neglected cases of undifferentiated disease (5). We have tested these criteria in a wide variety of rheumatic disorders in Alaskan Eskimos, in order to contribute to the necessary validation of these preliminary criteria. We report the results of our evaluation herein. PATIENTS AND METHODSA total of 104 patients with SPA were included in the evaluation. Sixty-six patients were identified during ongoing epidemiologic studies in the Barrow and Bristol Bay Health Service Units of the Alaska Area Native Health Service (AANHS), and 38 patients were known cases from previous epidemiologic studies in Kotzebue and the YukonKuskowim Delta (3,4). Initial identification of possible cases in the Barrow and Bristol Bay areas was accomplished primarily through the computerized patient care information system used by the AANHS (6,7). The medical records of patients identified as possible cases were then reviewed by the investigators. Those patients considered likely to have SpA were invited to attend special clinics for interview and examination in order to verify their diagnoses and collect the data necessary for evaluating the ESSG criteria (5).

Classification criteria for spondyloarthropathies

“…The ASAS criteria had the highest sensitivity compared to ESSG criteria and mNY criteria 98.4%, 83.6% and 71.9%, respectively [32] . In other studies of different ethnicities, lower sensitivity for mNY but similar sensitivity for ESSG was reported [33][34][35] . Recently, the French Society of Rheumatology presented the DESIR cohort.…”

Subclinical Sacroiliitis in Inflammatory Bowel Disease: A Clinical and Follow-up Study

“…The resultant sensitivity ranged from 40% to 46% and the corresponding PPVs were also low, suggesting that these criteria are not particularly helpful in the diagnosis of the milder forms of spondyloarthropathy. As whole, however, their high sensitivity and speci®city have been con®rmed in recent studies [19,20].…”

Nouveautés pour le diagnostic de spondylarthropathie

“…Le pourcentage dans la population générale de HLAB27 est de 5 à 10 % [10], en revanche, le pourcentage de ce marqueur tissulaire dans la spondylarthrite est de 80 à 95 % et de 70 % dans les spondylarthropathies indifféren-ciées [26]. L'utilisation de ce marqueur seul chez les lombalgiques chroniques n'a pas de valeur clinique diagnostique puisque la probabilité post-test n'excède pas 30 %, ce marqueur n'a de valeur que s'il est combiné aux autres paramètres cliniques et d'imagerie [12,[27][28][29] …”