Scores developed for risk stratification in inflammatory arthritis

A simple and a comprehensive score has been developed for persons at risk for inflammatory arthritis, according to a study published online Aug. 1 in the Annals of Internal Medicine.

Laurence Duquenne, M.D., from the University of Leeds in the United Kingdom, and colleagues developed scores for predicting inflammatory arthritis in at-risk persons using multidimensional biomarkers in a prospective observational cohort study. The simple score was developed using logistic regression, while the least absolute shrinkage and selection operator Cox proportional hazards regression was used to develop the comprehensive score.

Overall, 148 of the 455 participants (32.5%) developed inflammatory arthritis and 70 (15.4%) developed it within one year. The researchers found that the simple score identified 249 low-risk participants and 206 high-risk participants, with a false-negative rate of 5% and a false-positive rate of 72%, respectively. Totals of 119 high-risk participants and 336 low-risk participants were identified with the comprehensive score, with a false-positive and false-negative rate of 29% and 19%, respectively. Of the high-risk participants, 40 and 71% developed inflammatory arthritis within one and five years, respectively.

"The simple score is reproducible, economical, and practical for use in primary care with good negative predictive value of the low-risk group, who may not require referral. The comprehensive scores identify a high-risk population for intervention studies and for clinical management," the authors write. "These scores should have a positive effect on persons and health care systems."