Performance of the ASAS classification criteria for axial and peripheral spondyloarthritis: A systematic literature review and meta-analysis

A.R. Sepriano, R. Rubio, S. Ramiro, R. Landewé, D. Van Der Heijde

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Objective: To summarise the evidence on the performance of the Assessment of SpondyloArthritis international Society (ASAS) classification criteria for axial spondyloarthritis (axSpA) (also imaging and clinical arm separately), peripheral ( p)SpA and the entire set, when tested against the rheumatologist's diagnosis ('reference standard'). Methods: A systematic literature review was performed to identify eligible studies. Raw data on SpA diagnosis and classification were extracted or, if necessary, obtained from the authors of the selected publications. A meta-analysis was performed to obtain pooled estimates for sensitivity, specificity, positive and negative likelihood ratios, by fitting random effects models. Results: Nine papers fulfilled the inclusion criteria (N=5739 patients). The entire set of the ASAS SpA criteria yielded a high pooled sensitivity (73%) and specificity (88%). Similarly, good results were found for the axSpA criteria (sensitivity: 82%; specificity: 88%). Splitting the axSpA criteria in 'imaging arm only' and 'clinical arm only' resulted in much lower sensitivity (30% and 23% respectively), but very high specificity was retained (97% and 94% respectively). The pSpA criteria were less often tested than the axSpA criteria and showed a similarly high pooled specificity (87%) but lower sensitivity (63%). Conclusions: Accumulated evidence from studies with more than 5500 patients confirms the good performance of the various ASAS SpA criteria as tested against the rheumatologist's diagnosis. © 2017, BMJ Publishing Group. All rights reserved.
Original languageEnglish
Pages (from-to)886-890
Number of pages5
JournalAnnals of the rheumatic diseases
Volume76
Issue number5
DOIs
Publication statusPublished - 1 May 2017

Keywords

  • Article
  • Assessment of SpondyloArthritis international Society classification
  • cohort analysis
  • human
  • musculoskeletal system parameters
  • peripheral spondyloarthritis
  • population research
  • priority journal
  • prospective study
  • risk assessment
  • sensitivity and specificity
  • spondylarthritis
  • systematic review
  • classification
  • diagnostic imaging
  • meta analysis
  • sacroiliac joint
  • Spondylarthropathies
  • Humans
  • Sacroiliac Joint
  • Sensitivity and Specificity

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