Background/Purpose: Although there are various Psoriatic arthritis (PsA) screening questionnaires, the most optimal screening instrument is not known. The objective of the present study was to evaluate the sensitivity and specificity the four psoriatic arthritis screening tools (TOPAS II, PASE, PEST and EARP) in diagnosing Psoriatic Arthritis in patients with Psoriasis with CASPAR as gold standard.

Methods:

This was a non-interventional, cross sectional study in which 302 patients  diagnosed with PsO completed the Toronto Psoriatic Arthritis Screening Questionnaire (TOPAS II), Psoriatic Arthritis Screening And Evaluation (PASE), Psoriasis Epidemiology Screening Project (PEST) and Early Arthritis For Psoriasis Patients (EARP) prior to rheumatologic evaluation. The cutoff scores used in the original validation studies of these questionnaires were used to designate positive and negative cases.  Sensitivities and specificities of these questionnaires were determined by comparing the score with the diagnosis made by the CASPAR criteria.

Results:

Out of 302 patients with PsO, 45 had PsA according to CASPAR criteria (14.9%). 27 patients had a TOPAS II score of ≥8 suggestive of PsA. The mean TOPAS II score of the PsO patients was 2.93±2.6 and that of PsA patients was 6.84±1.9. 36 patients had a PEST questionnaire score of ≥3 suggestive of PsA. The mean PEST score of the PsO patients was 0.86±1.24, that of PsA patients was 2.73±1.45. For calculation of PASE score, 2 cutoffs were used separately. 50 patients had a PASE questionnaire score of ≥44 (recommended in a validation study of PASE) suggestive of PsA. 47 patients a PASE score 47(used in development of PASE questionnaire). 72 patients had EARP questionnaire score of ≥3 suggestive of PsA. The mean EARP score of the PsO patients was 1.44±2.33 and that of PsA patients was 5.47±2.25.The sensitivities and specificities of   EARP, PASE_44, PASE₄₇  PEST, and ToPAS II were 91.1%, 80%, 75.6%, 53.3%, 44.4%  and  87.9%,  94.6%, 94.9%, 95.3% 97.3% respectively.  

Conclusion: Out of the four screening questionnaires, EARP was most sensitivity while TOPAS II had least sensitivity. TOPASII had highest specificity while EARP had least specificity.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/comparison-of-the-four-validated-psoriatic-arthritis-screening-tools-in-diagnosing-psoriatic-arthritis-in-patients-with-psoriasis-compaq-study/