CARE referral rule bests REACH for detecting inflammatory arthritis, rheumatic disease – Healio
Source/Disclosures
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Disclosures:
The researchers report no relevant…….
Source/Disclosures
Published by:
Disclosures:
The researchers report no relevant financial disclosures.
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Compared to the Rotterdam Early Arthritis Cohort referral rule, the Clinical Arthritis Rule had superior specificity and overall diagnostic performance in recognizing inflammatory arthritis and inflammatory rheumatic disease in primary care.
However, researchers noted that a proposed composite rule, combining variables from both the REACH and CARE referral rules, demonstrated “a net benefit” and greater diagnostic performance “compared to the currently available rules.”
REACH and CARE show a net benefit in recognizing inflammatory arthritis and inflammatory rheumatic disease, researchers said. Data derived from van Delft ETAM, et al. Arthritis Care Res. 2021;doi:10.1002/acr.24789.
“At present there is a challenge for primary care physicians to refer patients suspect for inflammatory arthritis (IA) as quickly as possible,” Elke Theodora Antonia Maria van Delft, MSc, of Maasstad Hospital, in Rotterdam, the Netherlands, and colleagues wrote in Arthritis Care & Research. “Unfortunately, experience on who must be referred or in whom additional investigations are appropriate is lacking. Recently, two separate and distinct referral rules for arthritis have been developed to select patients for referral to the rheumatologist.”
“The aim of both rules was to assist in the decision-making process in patients with musculoskeletal symptoms with suspected IA, in order to promote early identification of IA,” they added. “Both referral rules could promote early identification of IA with the aim of increasing appropriate health care utilization.”
To analyze the performance and clinical use of the REACH and CARE referral rules in recognizing inflammatory arthritis and inflammatory rheumatic disease (IRD), van Delft and colleagues examined control group data from the JOINT referral study. According to the researchers, JOINT was a randomized, controlled trial intended to help general practitioners decide when to refer patients with musculoskeletal symptoms. Enrolled between April 2017 and November 2019, the control group included consecutive new patients who had been referred to the rheumatology outpatient clinic from the Maasstad hospital.
This referral process was conducted as usual based on national guidelines, without any other specific strategy.
For their own prospective, diagnostic study, van Delft and colleagues invited adult participants who were newly suspected of needing a rheumatology referral. In all, 250 patients suspected by their general practitioner of having an IRD were included in the analysis. These participants were seen by a research assistant prior to any consultation with a rheumatologist. During this meeting, patients answered questions in both the REACH and CARE strategies. Demographic data were also collected. The participants …….
