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Purpose
To investigate the validity of self-reported RA diagnoses in the general population and the overlap with other diagnoses, especially osteoarthritis.
Methods
The TNS Healthcare panel was used to access the general population (18 to 79 years; n = 70,112). Individuals at risk were identified in 2 stages by postal screening questionnaires pertaining to joint complaints and 14 common musculoskeletal diagnoses. The second questionnaire for the criteria positive responders replicated these 14 diagnoses. Responders who fulfilled our second set of selection criteria (modified ACR decision tree) were asked to participate in a clinical examination at one of 83 collaborating rheumatologists. Self-reported diagnoses were compared to clinically confirmed diagnoses.
Results
Of 54,976 Stage 1 respondents, 2,447 answered that they were told by a physician to have RA (4.5%). A total of 3,577 respondents fulfilled the criteria for the 2nd questionnaire (6.5%), which was answered by 3,048 of them (85%). According to our selection criteria, 1,187 were invited to a clinical examination and 643 agreed to attend. Until now, 30 RA patients were found in 278 clinical examinations. Another 15 were diagnosed with undifferentiated arthritis.
75% of all patients with confirmed RA had correctly reported their RA diagnosis in both stages; another 18% in at least one. However, 73% of the 233 participants with neither RA nor undifferentiated arthritis had reported RA in at least 1 of the 2 stages. Falsely reported RA diagnoses were equally common in participants with higher as well as lower educational levels and almost as common in those 46%, who had at least once consulted a rheumatologist. The highest proportions of falsely reported RA diagnoses were seen in respondents with osteoarthritis (OA) of the hands (96%), OA of hip, knee or shoulder (88%) and gout (86%). A self-reported DMARD therapy was the best predictor (RA confirmed in 71%), while self-reported signs and symptoms were weak predictors and multivariate analyses failed to identify a set of useful predictors for the correct diagnosis. 19% of the non-RA patients were diagnosed with other inflammatory rheumatic diseases and 87% with symptomatic OA in at least one region.
Conclusion
RA is correctly reported by most of the RA patients but frequently over-reported by the general population in Germany. This should be considered in research and clinical purposes.
Disclosure: Supported by an unconditional grant from Wyeth Pharma GmbH 2006-2007.
To investigate the validity of self-reported RA diagnoses in the general population and the overlap with other diagnoses, especially osteoarthritis.
Methods
The TNS Healthcare panel was used to access the general population (18 to 79 years; n = 70,112). Individuals at risk were identified in 2 stages by postal screening questionnaires pertaining to joint complaints and 14 common musculoskeletal diagnoses. The second questionnaire for the criteria positive responders replicated these 14 diagnoses. Responders who fulfilled our second set of selection criteria (modified ACR decision tree) were asked to participate in a clinical examination at one of 83 collaborating rheumatologists. Self-reported diagnoses were compared to clinically confirmed diagnoses.
Results
Of 54,976 Stage 1 respondents, 2,447 answered that they were told by a physician to have RA (4.5%). A total of 3,577 respondents fulfilled the criteria for the 2nd questionnaire (6.5%), which was answered by 3,048 of them (85%). According to our selection criteria, 1,187 were invited to a clinical examination and 643 agreed to attend. Until now, 30 RA patients were found in 278 clinical examinations. Another 15 were diagnosed with undifferentiated arthritis.
75% of all patients with confirmed RA had correctly reported their RA diagnosis in both stages; another 18% in at least one. However, 73% of the 233 participants with neither RA nor undifferentiated arthritis had reported RA in at least 1 of the 2 stages. Falsely reported RA diagnoses were equally common in participants with higher as well as lower educational levels and almost as common in those 46%, who had at least once consulted a rheumatologist. The highest proportions of falsely reported RA diagnoses were seen in respondents with osteoarthritis (OA) of the hands (96%), OA of hip, knee or shoulder (88%) and gout (86%). A self-reported DMARD therapy was the best predictor (RA confirmed in 71%), while self-reported signs and symptoms were weak predictors and multivariate analyses failed to identify a set of useful predictors for the correct diagnosis. 19% of the non-RA patients were diagnosed with other inflammatory rheumatic diseases and 87% with symptomatic OA in at least one region.
Conclusion
RA is correctly reported by most of the RA patients but frequently over-reported by the general population in Germany. This should be considered in research and clinical purposes.
Disclosure: Supported by an unconditional grant from Wyeth Pharma GmbH 2006-2007.
G. Westhoff, None; M. Schneider, None; H. Raspe, None; H. Zeidler, None; C. Runge, Wyeth Pharma, 3; T. Volmer, Wyeth Pharma, 3; A. Zink, None.
See more of: Epidemiology and Health Services Research III
See more of: ACR Abstract Submission Poster Sessions
See more of: ACR Abstract Submission Poster Sessions