Rheumatic?-A Digital Diagnostic Decision Support Tool for Individuals Suspecting Rheumatic Diseases: A Multicenter...

Area of Science:

• Rheumatology
• Digital Health
• Diagnostic Tools

Background:

• Digital diagnostic decision support tools can enhance efficiency in rheumatology.
• Rheumatic? is an online tool developed collaboratively by specialists, patients, and patient organizations.
• The tool calculates a risk score for various rheumatic diseases.

Purpose of the Study:

• To retrospectively test the pilot performance of the Rheumatic? tool.
• To evaluate its ability to differentiate immune-mediated rheumatic diseases from other musculoskeletal complaints.
• To assess its utility in patients visiting rheumatology clinics.

Main Methods:

• The Rheumatic? tool was tested across three university rheumatology centers.
• Datasets included patients at risk for RA, patients with early joint swelling, and patients with early arthritis of suspected autoimmune origin.
• Performance was evaluated using the Wilcoxon rank test and AUC-ROC, examining discriminative power and test characteristics at different scoring thresholds.

Main Results:

• The total score effectively differentiated between individuals developing arthritis and those who did not (AUC-ROC = 75.3).
• It also differentiated patients with immune-mediated arthritic disease (AUC-ROC = 79.0), though less effectively when autoimmune origin was already suspected by clinicians (AUC-ROC = 53.6).
• Threshold-1 showed high specificity in differentiating conditions, while Threshold-2 demonstrated very high specificity but low sensitivity for identifying patients needing rheumatologic care.

Conclusions:

• Rheumatic? is a web-based, patient-centered tool for differentiating immune-mediated rheumatic conditions.
• The tool has demonstrated capability in distinguishing these conditions from other musculoskeletal problems.
• Further optimization of the current scoring system is necessary to enhance its diagnostic accuracy and clinical application.