Dr. Walsh has received consulting fees (less than $10,000 each) from AbbVie, Celgene, and UCB.
Development and Testing of New Candidate Psoriatic Arthritis Screening Questionnaires Combining Optimal Questions From Existing Tools
Article first published online: 26 AUG 2014
Copyright © 2014 by the American College of Rheumatology
Arthritis Care & Research
Volume 66, Issue 9, pages 1410–1416, September 2014
How to Cite
Coates, L. C., Walsh, J., Haroon, M., FitzGerald, O., Aslam, T., Al Balushi, F., Burden, A. D., Burden-Teh, E., Caperon, A. R., Cerio, R., Chattopadhyay, C., Chinoy, H., Goodfield, M. J. D., Kay, L., Kelly, S., Kirkham, B. W., Lovell, C. R., Marzo-Ortega, H., McHugh, N., Murphy, R., Reynolds, N. J., Smith, C. H., Stewart, E. J. C., Warren, R. B., Waxman, R., Wilson, H. E. and Helliwell, P. S. (2014), Development and Testing of New Candidate Psoriatic Arthritis Screening Questionnaires Combining Optimal Questions From Existing Tools. Arthritis Care Res, 66: 1410–1416. doi: 10.1002/acr.22284
- Issue published online: 26 AUG 2014
- Article first published online: 26 AUG 2014
- Accepted manuscript online: 27 JAN 2014 01:51PM EST
- Manuscript Accepted: 14 JAN 2014
- Manuscript Received: 19 JUL 2013
Several questionnaires have been developed to screen for psoriatic arthritis (PsA), but head-to-head studies have found limitations. This study aimed to develop new questionnaires encompassing the most discriminative questions from existing instruments.
Data from the CONTEST study, a head-to-head comparison of 3 existing questionnaires, were used to identify items with a Youden index score of ≥0.1. These were combined using 4 approaches: CONTEST (simple additions of questions), CONTESTw (weighting using logistic regression), CONTESTjt (addition of a joint manikin), and CONTESTtree (additional questions identified by classification and regression tree [CART] analysis). These candidate questionnaires were tested in independent data sets.
Twelve individual questions with a Youden index score of ≥0.1 were identified, but 4 of these were excluded due to duplication and redundancy. Weighting for 2 of these questions was included in CONTESTw. Receiver operating characteristic (ROC) curve analysis showed that involvement in 6 joint areas on the manikin was predictive of PsA for inclusion in CONTESTjt. CART analysis identified a further 5 questions for inclusion in CONTESTtree. CONTESTtree was not significant on ROC curve analysis and discarded. The other 3 questionnaires were significant in all data sets, although CONTESTw was slightly inferior to the others in the validation data sets. Potential cut points for referral were also discussed.
Of 4 candidate questionnaires combining existing discriminatory items to identify PsA in people with psoriasis, 3 were found to be significant on ROC curve analysis. Testing in independent data sets identified 2 questionnaires (CONTEST and CONTESTjt) that should be pursued for further prospective testing.