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Welcome to SpA SIG. August 2, 2006. MR 304 : 15.30-16.30. How you diagnose and assess disease activity in AS: Results of a questionnaire study. Ratanavadee Nanagara, M.D. Allergy-Immunology-Rheumatology Unit KhonKaen University Thailand. Questionnaire.
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Welcome to SpA SIG August 2, 2006 MR 304 : 15.30-16.30
How you diagnose and assess disease activity in AS: Results of a questionnaire study Ratanavadee Nanagara, M.D. Allergy-Immunology-Rheumatology Unit KhonKaen University Thailand
Questionnaire parameters being used in common practice for diagnosis and assessment of AS patients. comments, suggestion, and revised by experience AS researchers 80 parameters for AS diagnosis, 32 for AS assessment electronically distributed
Purpose to assess the degree of importance of …parameters used for diagnosis and assessment of AS patients … ….. up to the individual opinion.. used in clinical practice, not in research…. * each item was scored as 1 or 2 or 3. 1 = not important 2 = moderate important 3 = extremely important “The must” *** rheumatologist running clinical practice for at least 5-10 years
31 responders from 10 APLAR countries Hongkong (4) Isaac YIM, Cheuk-wan Lai Shan Tam Lau Chak Sing Lee Ka Wing Australia (1) Lionel Schachna Taiwan (1) Chung-Tei Chou Indonesia (1) John Darmawan Philippines (4) Evelyn Salido Juan Javier Lichauco Julie Li Yu Sandra V. Navarra Korea (3) Sang-Hoon, Lee. Tae-Hwan Kim Tae Jong Kim India (4) Ashok Kumar Rohini Handa Ved Chaturvedi Vikas Agarwal Thailand (4) Boonjing Siripaitoon Ratanavadee Nanagara Sittichai Ukritchon Worawit Laoraenu Results analysis Malaysia (4) Gun Suk Chyn Lew LWG Swan Sim Yeap Swee Gaik Ong Singapore (5) Anita Lim Chew Li-Ching Julian Thumboo Kok Ooi Kong Spore Bernard Thong
> 80% of responders scored as important ( 2 + 3) Parameter for diagnosis 43 / 57 clinical parts 9 / 23 Lab. tests including: CRP, ESR, most plain films, and MRI 70% agree with B-27 study, less with RF Parameter for assessment 29 / 32 items listed Including: VAS, BASFI, BASDAI, GA, +BASMI
> 80% of responders scored as “The Must” (3) Parameter for diagnosis Inflammatory back pain, morning pain, Schober test 433 / 57 clinical parts 9 1 / 23 Lab. tests film pelvis Parameter for assessment 291 / 32 items listed Schober test
> 60% of responders scored as “The Must” (3) Parameter for diagnosis back pain characteristics eye sign, sausage digits chest expansion 43310 / 57 clinical parts 911 / 23 Lab. tests film pelvis 50% scored for MRI, 30% scored for B-27 Parameter for assessment Schober, morning pain peripheral joints & eye exam, VAS (pain, global), BASDAI, 291 6 / 32 items listed 50-60 % scored for chest expansion, enthesitis BASFI, CRP, ESR
Conclusion (1) • Majority of the responders agree that most parameters used for diagnosis and assessment of AS patients are important. 2. However, limited numbers of these parameters have been using in their clinical practice. 3. At least, characteristics of back pain, Schober test, chest and eye exam, and film pelvis were evaluated by 80% of the responders.
Conclusion (2) 4. About half used MRI of SI joint for AS diagnosis, while one third need genetic study. 5. Half of the responders used AS measurement parameters (BASDAI, BASFI, VAS) and inflammatory parameters (CRP, ESR) during AS assessment for their optimal care.
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> 70% > 50% used in clinical practice
> 70% > 50% used in clinical practice
> 70% > 50% used in clinical practice
> 70% > 50% used in clinical practice
> 70% > 50% used in clinical practice
> 70% > 50% used in clinical practice