Article Text

SAT0078 The Need to Perform an Impact Study before Using Referral Models for Axial Spondyloarthritis in Daily Practice
  1. L. Van Hoeven1,2,
  2. Y. Vergouwe3,
  3. M. Hazes1,
  4. A. Weel1,2
  1. 1Rheumatology, Erasmus Medical Centre
  2. 2Rheumatology, Maasstad Hospital, Rotterdam
  3. 3Public Health, Erasmus Medical Centre, Rotterdam, Netherlands


Background Unfortunately, only a small part of all published prediction models is used in daily practice, an explanation can be a lack of efficacy or practical feasibility. Therefore prediction modeling research recommends to perform three study phases before using the model in daily practice: (1) developing and internally validating (2) external validation and updating; (3) assessing the model's impact on decision making and patient outcomes. Axial spondyloarthritis (axSpA) is characterized by a diagnostic delay, the time between the first symptoms and final diagnosis is on average 7-10 years. This delay requires a prediction model that can early identify possible axSpA patients in the large group of chronic low back pain (CLBP) patients.

Objectives To identify all published prediction models (e.g. referral rule or screening methods) for axial spondyloarthritis (axSpA) and to investigate in which prediction modelling phase this model is.

Methods Publications describing a prediction model, screening method, or referral rule for axSpA were identified by an Embase and Medline search, at January 29, 2014. After reading all articles we scored which prediction models had been externally validated and whether an impact study had been performed.

Results In total 11 studies were identified, all presenting a prediction model for axSpA, applicable in patients with CLBP. Ten studies were developing studies and only one study performed an external validation. So far, none of these studies have performed an impact analysis.

Conclusions Of all published prediction models for axSpA only one has been externally validated. Before using any prediction or referral model for axSpA in daily practice, we advise to perform an impact study to investigate the impact of a prediction model on decision making and patient outcomes


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Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.5177

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