Turkiye Klinikleri Journal of Dermatology

.: ORIGINAL RESEARCH
Reliability and Sensitivity of a New Simple Screening Test (TUPAST) in Psoriatic Arthritis Including Axial Involvement: Methodological Study
Yeni, Basit Tarama Testinin (TUPAST) Aksiyal Tutulumu da İçeren Psöriyatik Artrit Hastalarında Güvenilirlik ve Duyarlılığı: Metodolojik Çalışma
Nahide ONSUNa , Ozan Volkan YURDAKULb , Begüm GÜNEŞa , Elif UĞURLUb , Ayşegül YABACI TAKc , Didem DİZMANd , Nazan TAŞLIDEREe
aBiruni University Faculty of Medicine, Department of Dermatology, İstanbul, Türkiye
bBezmialem Vakıf University Faculty of Medicine, Department of Physical Therapy and Rehabilitation, İstanbul, Türkiye
cBezmialem Vakıf University Faculty of Medicine, Department of Biostatistics and Medical Informatics, İstanbul, Türkiye
dBezmialem Vakıf University Faculty of Medicine, Department of Dermatology, İstanbul, Türkiye
eLevent Hospital, Clinic of Dermatology, İstanbul, Türkiye
Turkiye Klinikleri J Dermatol. 2024;34(3):93-8
doi: 10.5336/dermato.2023-100381
Article Language: EN
Full Text
ABSTRACT
 Objective: Early detection of psoriatic arthritis (PsA) can prevent destruction and functional disabilities. Dermatologists play an important role in the early diagnosis and treatment of PsA. The aim of the study was to develop a practical questionnaire that does not take long time for early diagnosis of PsA and for not to overlook axial involvement. Material and Methods: This was a prospective study including 200 psoriasis patients. Turkish Psoriatic Arthritis Screening Tool (TUPAST) questions were designed in a simple and plain language that the patients could easily understand. Patients were asked to answer these 6 questions and the well-known questionnaire Toronto Psoriatic Arthritis Screening 2 (ToPAS 2) synchronously. Results: ROC analysis was performed to determine the cut-off value of TUPAST, and the cut-off value was determined as 3. The sensitivity of the cut-off value was calculated as 54.32% and the specificity as 90.68%. The cut-off value obtained for ToPAS 2 was 8 and its sensitivity was 79%, and specificity was 55% in our patient population. There was a significant difference between two tests in terms of time spent for answering questions (TUPAST-0.5 minute, ToPAS 2-3.6 minute) (p<0.05). Conclusion: PsA screening by dermatologist can be the first step in diagnosis of joint involvement in psoriasis. Due to the heavy patient traffic of dermatology outpatient clinics, we need tests that do not take much time. TUPAST is a simple and time saving screening test that takes only 30 seconds to answer and can be used in prediagnosis of PsA.

Keywords: Psoriasis; psoriatic arthritis; screening test; Toronto Psoriatic Arthritis Screening 2; Turkish Psoriatic Arthritis Screening Tool
ÖZET
 Amaç: Psöriyatik artritin (PsA) erken tespiti, eklem destrüksiyonu ve işlev kaybını önleyebilir. Dermatologlar, PsA'nın erken tanı ve tedavisinde önemli bir rol oynamaktadır. Çalışmamızın amacı, PsA'nın erken tanısı için uzun zaman almayan ve aksiyel tutulumu gözden kaçırmayan pratik bir anket geliştirmektir. Gereç ve Yöntemler: Çalışmamız, 200 psöriyazis hastasını kapsayan prospektif bir çalışmaydı. Türk Psoriatik Artrit Tarama Anketi [Turkish Psoriatic Arthritis Screening Tool (TUPAST)] soruları hastaların anlayabileceği sade bir dilde hazırlandı. Hastalardan bu 6 soru ve Toronto Psoriatik Artrit Tarama 2 [Toronto Psoriatic Arthritis Screening 2 (ToPAS 2)] anketini eş zamanlı olarak cevaplamaları istendi. Bulgular: TUPAST'ın eşik değerini belirlemek için ROC analizi yapıldı ve eşik değeri 3 olarak belirlendi. Eşik değerin duyarlılığı %54,32, özgüllüğü %90,68 olarak hesaplandı. ToPAS 2 için elde edilen eşik değer 8 olup duyarlılığı %79, özgüllüğü ise hasta popülasyonumuzda %55 olarak bulundu. Soruları cevaplamak için harcanan süre açısından iki test arasında anlamlı fark vardı (TUPAST-0,5 dk, ToPAS 2-3,6 dk) (p<0,05). Sonuç: Dermatolog tarafından yapılan PsA taraması, sedef hastalığının eklem tutulumunun tanısında ilk adım olabilir. Dermatoloji polikliniklerinin yoğun hasta trafiğinden dolayı fazla zaman almayan testlere ihtiyaç duyulmaktadır. TUPAST, PsA ön tanısında kullanılabilen, cevaplanması sadece 30 sn süren, basit ve zaman kazandıran bir tarama testidir.

Anahtar Kelimeler: Psöriyazis; psöriyatik artrit; tarama testi; Toronto Psoriatik Artrit Tarama 2; Türk Psoriatik Artrit Tarama Anketi
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