Autoimmune rheumatic diseases and manifestations for population screening: a consensus development study

Self-administered screening questionnaires are one of the key strategies to shorten diagnostic delay among patients with autoimmune rheumatic diseases (ARDs). However, most existing screening questionnaires for ARDs were developed to screen for one or a limited number of ARDs, and thus have limited utility when the goal is to screen for common ARDs. We aimed to develop a list of ARDs for population screening, and based on this, a list of manifestations to be assessed in a screening questionnaire for ARDs.

This study comprised two phases: Phase 1 involved the development of a list of ARDs through a modified Delphi study with accredited rheumatologists and Phase 2 involved the development of a list of manifestations through a modified nominal group technique with accredited rheumatologists, other healthcare professionals caring for patients with ARDs, and patients with ARDs.

In Phase 1, 14 candidate ARDs were identified using a multipronged approach, ten of which were deemed necessary to be screened for in the general population, through three rounds of Delphi exercise. In Phase 2, 80 candidate manifestations of these ten ARDs were identified from a literature review. Of these, 59 manifestations were deemed necessary to be assessed in a screening questionnaire through one round of prenominal group dialogue and two rounds of nominal group discussion.

Consensus-based lists of ARDs and their manifestations were developed in this study. They provide a basis for developing new ARD screening questionnaires to facilitate early diagnosis of ARDs in the general population.