Screening for signs and symptoms of rheumatoid arthritis by family physicians and nurse practitioners using the Gait, Arms, Legs, and Spine musculoskeletal examination
Article first published online: 28 NOV 2012
Copyright © 2012 by the American College of Rheumatology
Arthritis Care & Research
Volume 64, Issue 12, pages 1923–1927, December 2012
How to Cite
Beattie, K. A., MacIntyre, N. J. and Cividino, A. (2012), Screening for signs and symptoms of rheumatoid arthritis by family physicians and nurse practitioners using the Gait, Arms, Legs, and Spine musculoskeletal examination. Arthritis Care Res, 64: 1923–1927. doi: 10.1002/acr.21740
- Issue published online: 28 NOV 2012
- Article first published online: 28 NOV 2012
- Accepted manuscript online: 23 MAY 2012 03:09PM EST
- Manuscript Accepted: 7 MAY 2012
- Manuscript Received: 26 JAN 2012
- Canadian Initiative for Outcomes in Rheumatology Care grant
- Network Scholar Award through the Canadian Arthritis Network/The Arthritis Society
To evaluate the sensitivity and specificity of the Gait, Arms, Legs, and Spine (GALS) examination to screen for signs and symptoms of rheumatoid arthritis (RA) when used by family physicians and nurse practitioners.
Participating health care professionals (2 rheumatologists, 3 family physicians, and 3 nurse practitioners) were trained to perform the GALS examination by viewing an instructional DVD and attending a training workshop. One week after training, the health care professionals performed the GALS examination on 20 individuals with RA and 21 individuals without RA. All participants were recruited through 2 rheumatology practices, and each participant was assessed by 4 health care professionals. The health care professionals were asked to record whether observed signs and symptoms were potentially consistent with a diagnosis of RA. The health care professionals understood the study objective to be their agreement on GALS findings among one another and were unaware that one-half of the participants had RA. Sensitivity and specificity were calculated to determine the ability of the GALS examination to screen for RA using the rheumatologist as the standard for comparison.
Sensitivity and specificity values varied from 60–100% and 70–82%, respectively, for the 3 family physicians, and 60–90% and 73–100%, respectively, for the 3 nurse practitioners.
Following a very short training period, family physicians and nurse practitioners appeared to be able to use the GALS examination as a screening tool for RA signs and symptoms, particularly for identifying an individual with positive results who will benefit from further investigation or rheumatology referral.