Sensitivity, specificity, and positive likelihood ratios (LRs) of clinical and laboratory SpA features in patients with ankylosing spondylitis (AS), controls with back pain, patients with any spondyloarthritis, or any controls. Listing of references according to the year of publication
Sens. (%) | Spec. (%) | Positive LR | Group of patients and size of study group | Ref. | ||||
---|---|---|---|---|---|---|---|---|
AS (n) | Back pain controls (n) | All SpA (n) | Controls (n)* | |||||
Figures in bold indicate the sensitivities, specificities, and positive LRs taken in our calculations. | ||||||||
*Controls were in general patients with musculoskeletal diseases other than SpA; †apparently healthy sportsmen who had had an episode of back pain; ‡data on control patients were not available. Thus, the prevalence in the general population was assumed; §data from a German observational study on SpA (AS n = 138, unpublished); ¶sensitivity of HLA-B27 refers to SpA with axial involvement—that is, with inflammatory back pain; **MRI denotes magnetic resonance imaging. | ||||||||
Inflammatory back pain | 95 | 76 | 4.0 | 42 | 21 | 22 | ||
38 | 100 | ~ | 21 | 83 | 10 | |||
65 | 79 | 3.1 | 27 | 422 | 25 | |||
– | 75† | 774 | 24 | |||||
71 | 80 | 3.6 | 101 | 112 | 21 | |||
75 | 76 | 3.1 | ||||||
Alternating buttock pain | 20 | 97 | 6.6 | 403 | 674 | 14 | ||
39 | 98 | 19.5 | 124 | 1964 | 16 | |||
20 | 89 | 1.8 | 104 | 75 | 27 | |||
43 | 95 | 9.6 | 218 | 1242 | 28 | |||
43 | 100 | ~ | 44 | 29 | 30 | |||
32 | 97 | 10.4 | 105 | 163 | 31 | |||
37 | 88 | 3.7 | 101 | 112 | 21 | |||
40 | 90 | 4.0 | ||||||
Heel pain (enthesitis) | 16 | 90 | 1.6 | 70 | 32 | 34 | ||
37 | 89 | 3.4 | 403 | 674 | 14 | |||
25 | 90 | 2.5 | 104 | 75 | 27 | |||
52 | 92 | 6.5 | 124 | 1964 | 16 | |||
47 | 94 | 7.8 | 218 | 1242 | 28 | |||
50 | 96 | 12.5 | 44 | 29 | 30 | |||
52 | 93 | 7.4 | 105 | 163 | 31 | |||
37 | 89 | 3.4 | ||||||
Peripheral arthritis | 41 | 94 | 6.8 | 70 | 32 | 34 | ||
40 | 90 | 4.0 | 403 | 674 | 14 | |||
44 | 95 | 8.8 | 124 | 1964 | 16 | |||
42 | 91 | 4.7 | 218 | 1242 | 28 | |||
62 | 100 | ~ | 44 | 29 | 30 | |||
26 | 98 | 13 | 105 | 163 | 31 | |||
40 | 90 | 4.0 | ||||||
Dactylitis | 18 | 96 | 4.5 | 403 | 674 | 14 | ||
27 | 99 | 27 | 124 | 1964 | 16 | |||
24 | 96 | 6 | 218 | 1242 | 28 | |||
12 | 98 | 6 | 105 | 163 | 31 | |||
18 | 96 | 4.5 | ||||||
Anterior uveitis | 10 | 100 | ~ | 70 | 32 | 34 | ||
19 | – | 42 | 12 | 12 | ||||
22 | 97 | 7.3 | 403 | 674 | 14 | |||
14 | 99 | 14 | 124 | 1964 | 16 | |||
13 | 99 | 13 | 218 | 1242 | 28 | |||
4 | 100 | ~ | 105 | 163 | 31 | |||
21 | – | 676 | 29 | |||||
22 | 97 | 7.3 | ||||||
Psoriasis | 17 | – | 807 | 39 | ||||
1.2 | – | 676 | 29 | |||||
10 | 96‡ | 2.5 | 29 | |||||
Inflammatory bowel disease | 7 | – | 828 | 39 | ||||
1.7 | – | 676 | 29 | |||||
4 | 99‡ | 4 | ||||||
Positive family history for AS, reactive arthritis, IBD, psoriasis, anterior uveitis | 7 | 100 | ~ | 70 | 32 | 34 | ||
31 | 93 | 4.4 | 104 | 75 | 27 | |||
32 | 95 | 6.4 | 403 | 674 | 14 | |||
36 | 97 | 12 | 218 | 1242 | 28 | |||
20 | 100 | ~ | 44 | 29 | 30 | |||
15 | 99 | 15 | 105 | 163 | 31 | |||
10 | – | 676 | 29 | |||||
32 | 95 | 6.4 | ||||||
Response to NSAIDs | 77 | 85 | 5.1 | 69 | 769 | 16 | ||
71 | 75 | 2.8 | 218 | 1242 | 28 | |||
61 | 80 | 3.1 | 105 | 163 | 31 | |||
64 | – | 676 | 29 | |||||
77 | 85 | 5.1 | ||||||
Raised acute phase reactants (CRP) | 49 | 100 | ~ | 70 | 32 | 34 | ||
69 | 67 | 3 | 42 | 12 | 12 | |||
39 | – | 443 | 35 | |||||
38 | – | 149 | 36 | |||||
75 | – | 70 | 7 | |||||
51 | 75 | 2 | 101 | 112 | 21 | |||
56§ | – | |||||||
50 | 80 | 2.5 | ||||||
HLA-B27 | 96 | 96 | 24 | 40 | 906 | 37 | ||
88 | 92 | 11 | 75 | 75 | 38 | |||
83 | 95 | 16.6 | 70 | 32 | 34 | |||
88 | – | 42 | 12 | 12 | ||||
– | 91 | 1871 | 3 | |||||
89 | 94 | 14.8 | 101 | 112 | 21 | |||
90¶ | 90 | 9.0 | ||||||
MRI** | 93 | 100 | ~ | 25 | 12 | 15 | 40 | |
54 | 83 | 3.1 | 12 | 24 | 41 | |||
83 | 93 | 11.8 | 36 | 53 | 36 | 42 | ||
94 | 100 | ~ | 20 | 17 | 43 | |||
90 | – | 41 | 44 | |||||
90 | 90 | 9.0 |