Development and testing of new candidate psoriatic arthritis screening questionnaires combining optimal questions from existing tools

Laura C Coates, Jessica Walsh, Muhammad Haroon, Oliver Fitzgerald, Tariq Aslam, Farida Al Balushi, A D Burden, Esther Burden-Teh, Anna R Caperon, Rino Cerio, Chandrabhusan Chattopadhyay, Hector Chinoy, Mark J D Goodfield, Lesley Kay, Stephen Kelly, Bruce W Kirkham, Christopher R Lovell, Helena Marzo-Ortega, Neil McHugh, Ruth Murphy & 7 others Nick J Reynolds, Catherine H Smith, Elizabeth J C Stewart, Richard B Warren, Robin Waxman, Hilary E Wilson, Philip S Helliwell

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Abstract

Objective: Several questionnaires have been developed to screen for psoriatic arthritis (PsA) but head to head studies have found limitations. This study aimed to develop new questionnaires encompassing the most discriminative questions from existing instruments. Methods: Data from the CONTEST study, a head to head comparison of three existing questionnaires, were used to identify items with a Youden's index of ≥0.1. These were combined using four approaches: CONTEST- simple additions of questions; CONTESTw- weighting using logistic regression; CONTESTjt- addition of a joint manikin and CONTESTtree- additional questions identified by CART analysis. These candidate questionnaires were tested in independent datasets. Results: 12 individual questions with a Youden's index of ≥0.1 were identified but 4 of these were excluded due to duplication and redundancy. Weighting for two of these questions, was included in CONTESTw. Receiver operating characteristic (ROC) curve analysis showed that involvement in six joint areas on the manikin was predictive of PsA for inclusion in CONTESTjt. CART analysis identified a further 5 questions for inclusion in CONTESTtree. CONTESTtree was not significant on ROC analysis and discarded. The other three were significant in all datasets, although CONTESTw was slightly inferior to the others in the validation datasets. Potential cut points for referral are discussed. Conclusion: Of four candidate questionnaires combining existing discriminatory items to identify psoriatic arthritis in people with psoriasis three were found to be significant on ROC analysis. Testing in independent datasets identifies two questionnaires: CONTEST and CONTESTjt that should be pursued for further prospective testing.
LanguageEnglish
Pages1410-1416
Number of pages27
JournalArthritis Care and Research
Volume66
Issue number9
DOIs
StatusPublished - 27 Jan 2014

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Psoriatic Arthritis
ROC Curve
Manikins
Joints
Psoriasis
Surveys and Questionnaires
Referral and Consultation
Logistic Models
Datasets

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Coates, L. C., Walsh, J., Haroon, M., Fitzgerald, O., Aslam, T., Al Balushi, F., ... Helliwell, P. S. (2014). Development and testing of new candidate psoriatic arthritis screening questionnaires combining optimal questions from existing tools. Arthritis Care and Research, 66(9), 1410-1416. https://doi.org/10.1002/acr.22284

Development and testing of new candidate psoriatic arthritis screening questionnaires combining optimal questions from existing tools. / Coates, Laura C; Walsh, Jessica; Haroon, Muhammad; Fitzgerald, Oliver; Aslam, Tariq; Al Balushi, Farida; Burden, A D; Burden-Teh, Esther; Caperon, Anna R; Cerio, Rino; Chattopadhyay, Chandrabhusan; Chinoy, Hector; Goodfield, Mark J D; Kay, Lesley; Kelly, Stephen; Kirkham, Bruce W; Lovell, Christopher R; Marzo-Ortega, Helena; McHugh, Neil; Murphy, Ruth; Reynolds, Nick J; Smith, Catherine H; Stewart, Elizabeth J C; Warren, Richard B; Waxman, Robin; Wilson, Hilary E; Helliwell, Philip S.

In: Arthritis Care and Research, Vol. 66, No. 9, 27.01.2014, p. 1410-1416.

Research output: Contribution to journalArticle

Coates, LC, Walsh, J, Haroon, M, Fitzgerald, O, Aslam, T, Al Balushi, F, Burden, AD, Burden-Teh, E, Caperon, AR, Cerio, R, Chattopadhyay, C, Chinoy, H, Goodfield, MJD, Kay, L, Kelly, S, Kirkham, BW, Lovell, CR, Marzo-Ortega, H, McHugh, N, Murphy, R, Reynolds, NJ, Smith, CH, Stewart, EJC, Warren, RB, Waxman, R, Wilson, HE & Helliwell, PS 2014, 'Development and testing of new candidate psoriatic arthritis screening questionnaires combining optimal questions from existing tools' Arthritis Care and Research, vol. 66, no. 9, pp. 1410-1416. https://doi.org/10.1002/acr.22284
Coates, Laura C ; Walsh, Jessica ; Haroon, Muhammad ; Fitzgerald, Oliver ; Aslam, Tariq ; Al Balushi, Farida ; Burden, A D ; Burden-Teh, Esther ; Caperon, Anna R ; Cerio, Rino ; Chattopadhyay, Chandrabhusan ; Chinoy, Hector ; Goodfield, Mark J D ; Kay, Lesley ; Kelly, Stephen ; Kirkham, Bruce W ; Lovell, Christopher R ; Marzo-Ortega, Helena ; McHugh, Neil ; Murphy, Ruth ; Reynolds, Nick J ; Smith, Catherine H ; Stewart, Elizabeth J C ; Warren, Richard B ; Waxman, Robin ; Wilson, Hilary E ; Helliwell, Philip S. / Development and testing of new candidate psoriatic arthritis screening questionnaires combining optimal questions from existing tools. In: Arthritis Care and Research. 2014 ; Vol. 66, No. 9. pp. 1410-1416.
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abstract = "Objective: Several questionnaires have been developed to screen for psoriatic arthritis (PsA) but head to head studies have found limitations. This study aimed to develop new questionnaires encompassing the most discriminative questions from existing instruments. Methods: Data from the CONTEST study, a head to head comparison of three existing questionnaires, were used to identify items with a Youden's index of ≥0.1. These were combined using four approaches: CONTEST- simple additions of questions; CONTESTw- weighting using logistic regression; CONTESTjt- addition of a joint manikin and CONTESTtree- additional questions identified by CART analysis. These candidate questionnaires were tested in independent datasets. Results: 12 individual questions with a Youden's index of ≥0.1 were identified but 4 of these were excluded due to duplication and redundancy. Weighting for two of these questions, was included in CONTESTw. Receiver operating characteristic (ROC) curve analysis showed that involvement in six joint areas on the manikin was predictive of PsA for inclusion in CONTESTjt. CART analysis identified a further 5 questions for inclusion in CONTESTtree. CONTESTtree was not significant on ROC analysis and discarded. The other three were significant in all datasets, although CONTESTw was slightly inferior to the others in the validation datasets. Potential cut points for referral are discussed. Conclusion: Of four candidate questionnaires combining existing discriminatory items to identify psoriatic arthritis in people with psoriasis three were found to be significant on ROC analysis. Testing in independent datasets identifies two questionnaires: CONTEST and CONTESTjt that should be pursued for further prospective testing.",
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AU - Coates, Laura C

AU - Walsh, Jessica

AU - Haroon, Muhammad

AU - Fitzgerald, Oliver

AU - Aslam, Tariq

AU - Al Balushi, Farida

AU - Burden, A D

AU - Burden-Teh, Esther

AU - Caperon, Anna R

AU - Cerio, Rino

AU - Chattopadhyay, Chandrabhusan

AU - Chinoy, Hector

AU - Goodfield, Mark J D

AU - Kay, Lesley

AU - Kelly, Stephen

AU - Kirkham, Bruce W

AU - Lovell, Christopher R

AU - Marzo-Ortega, Helena

AU - McHugh, Neil

AU - Murphy, Ruth

AU - Reynolds, Nick J

AU - Smith, Catherine H

AU - Stewart, Elizabeth J C

AU - Warren, Richard B

AU - Waxman, Robin

AU - Wilson, Hilary E

AU - Helliwell, Philip S

N1 - Copyright © 2014 American College of Rheumatology.

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Y1 - 2014/1/27

N2 - Objective: Several questionnaires have been developed to screen for psoriatic arthritis (PsA) but head to head studies have found limitations. This study aimed to develop new questionnaires encompassing the most discriminative questions from existing instruments. Methods: Data from the CONTEST study, a head to head comparison of three existing questionnaires, were used to identify items with a Youden's index of ≥0.1. These were combined using four approaches: CONTEST- simple additions of questions; CONTESTw- weighting using logistic regression; CONTESTjt- addition of a joint manikin and CONTESTtree- additional questions identified by CART analysis. These candidate questionnaires were tested in independent datasets. Results: 12 individual questions with a Youden's index of ≥0.1 were identified but 4 of these were excluded due to duplication and redundancy. Weighting for two of these questions, was included in CONTESTw. Receiver operating characteristic (ROC) curve analysis showed that involvement in six joint areas on the manikin was predictive of PsA for inclusion in CONTESTjt. CART analysis identified a further 5 questions for inclusion in CONTESTtree. CONTESTtree was not significant on ROC analysis and discarded. The other three were significant in all datasets, although CONTESTw was slightly inferior to the others in the validation datasets. Potential cut points for referral are discussed. Conclusion: Of four candidate questionnaires combining existing discriminatory items to identify psoriatic arthritis in people with psoriasis three were found to be significant on ROC analysis. Testing in independent datasets identifies two questionnaires: CONTEST and CONTESTjt that should be pursued for further prospective testing.

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