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Colour Doppler ultrasound and the giant cell arteritis probability score for the diagnosis of giant cell arteritis: a Canadian single-centre experience
OBJECTIVES: The aim was to compare the accuracy of colour Doppler ultrasonography (CDUS) and temporal artery biopsy (TAB) to establish the final diagnosis of GCA and to determine how the GCA probability score (GCAPS) performs as a risk stratification tool. METHODS: Descriptive statistics were perfor...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8633428/ https://www.ncbi.nlm.nih.gov/pubmed/34859177 http://dx.doi.org/10.1093/rap/rkab083 |
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author | Zarka, Farah Rhéaume, Maxime Belhocine, Meriem Goulet, Michelle Febrer, Guillaume Mansour, Anne-Marie Troyanov, Yves Starnino, Tara Meunier, Rosalie-Sélène Chagnon, Isabelle Routhier, Nathalie Bénard, Valérie Ducharme-Bénard, Stéphanie Ross, Carolyn Makhzoum, Jean-Paul |
author_facet | Zarka, Farah Rhéaume, Maxime Belhocine, Meriem Goulet, Michelle Febrer, Guillaume Mansour, Anne-Marie Troyanov, Yves Starnino, Tara Meunier, Rosalie-Sélène Chagnon, Isabelle Routhier, Nathalie Bénard, Valérie Ducharme-Bénard, Stéphanie Ross, Carolyn Makhzoum, Jean-Paul |
author_sort | Zarka, Farah |
collection | PubMed |
description | OBJECTIVES: The aim was to compare the accuracy of colour Doppler ultrasonography (CDUS) and temporal artery biopsy (TAB) to establish the final diagnosis of GCA and to determine how the GCA probability score (GCAPS) performs as a risk stratification tool. METHODS: Descriptive statistics were performed on a retrospective cohort of patients referred to our vasculitis referral centre between 1 July 2017 and 1 October 2020 for suspected GCA. CDUS, TAB, centre-specific TAB (vasculitis centre vs referring hospitals) and GCAPS were compared against the final diagnosis of GCA as determined by a GCA expert; CDUS was also compared with TAB results. RESULTS: Data from 198 patients were included: 60 patients with GCA and 138 patients without GCA. Sixty-two patients had a TAB. Using the final diagnosis by a GCA expert as a reference, the sensitivity, specificity, positive predictive value and negative predictive value were 93.3%, 98.5%, 96.6% and 97.1% for CDUS and 69.2%, 100%, 100% and 81.8% for TAB, respectively. The false-negative rate was 6.7% for CDUS and 30.8% for TAB. False-negative TAB mostly occurred when performed in referring hospitals (57.1%) as opposed to our vasculitis centre (21.1%). With a cut-off at 9.5 points, sensitivity for GCAPS was 98.3% and specificity 74.3%. CONCLUSION: CDUS of the temporal and axillary arteries showed a high sensitivity and specificity and helped to diagnose GCA in patients with negative TAB. We validated that GCAPS is a useful clinical tool, with a score of <9.5 making the diagnosis of GCA improbable. |
format | Online Article Text |
id | pubmed-8633428 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-86334282021-12-01 Colour Doppler ultrasound and the giant cell arteritis probability score for the diagnosis of giant cell arteritis: a Canadian single-centre experience Zarka, Farah Rhéaume, Maxime Belhocine, Meriem Goulet, Michelle Febrer, Guillaume Mansour, Anne-Marie Troyanov, Yves Starnino, Tara Meunier, Rosalie-Sélène Chagnon, Isabelle Routhier, Nathalie Bénard, Valérie Ducharme-Bénard, Stéphanie Ross, Carolyn Makhzoum, Jean-Paul Rheumatol Adv Pract Original Article OBJECTIVES: The aim was to compare the accuracy of colour Doppler ultrasonography (CDUS) and temporal artery biopsy (TAB) to establish the final diagnosis of GCA and to determine how the GCA probability score (GCAPS) performs as a risk stratification tool. METHODS: Descriptive statistics were performed on a retrospective cohort of patients referred to our vasculitis referral centre between 1 July 2017 and 1 October 2020 for suspected GCA. CDUS, TAB, centre-specific TAB (vasculitis centre vs referring hospitals) and GCAPS were compared against the final diagnosis of GCA as determined by a GCA expert; CDUS was also compared with TAB results. RESULTS: Data from 198 patients were included: 60 patients with GCA and 138 patients without GCA. Sixty-two patients had a TAB. Using the final diagnosis by a GCA expert as a reference, the sensitivity, specificity, positive predictive value and negative predictive value were 93.3%, 98.5%, 96.6% and 97.1% for CDUS and 69.2%, 100%, 100% and 81.8% for TAB, respectively. The false-negative rate was 6.7% for CDUS and 30.8% for TAB. False-negative TAB mostly occurred when performed in referring hospitals (57.1%) as opposed to our vasculitis centre (21.1%). With a cut-off at 9.5 points, sensitivity for GCAPS was 98.3% and specificity 74.3%. CONCLUSION: CDUS of the temporal and axillary arteries showed a high sensitivity and specificity and helped to diagnose GCA in patients with negative TAB. We validated that GCAPS is a useful clinical tool, with a score of <9.5 making the diagnosis of GCA improbable. Oxford University Press 2021-11-10 /pmc/articles/PMC8633428/ /pubmed/34859177 http://dx.doi.org/10.1093/rap/rkab083 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Rheumatology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Original Article Zarka, Farah Rhéaume, Maxime Belhocine, Meriem Goulet, Michelle Febrer, Guillaume Mansour, Anne-Marie Troyanov, Yves Starnino, Tara Meunier, Rosalie-Sélène Chagnon, Isabelle Routhier, Nathalie Bénard, Valérie Ducharme-Bénard, Stéphanie Ross, Carolyn Makhzoum, Jean-Paul Colour Doppler ultrasound and the giant cell arteritis probability score for the diagnosis of giant cell arteritis: a Canadian single-centre experience |
title | Colour Doppler ultrasound and the giant cell arteritis probability score for the diagnosis of giant cell arteritis: a Canadian single-centre experience |
title_full | Colour Doppler ultrasound and the giant cell arteritis probability score for the diagnosis of giant cell arteritis: a Canadian single-centre experience |
title_fullStr | Colour Doppler ultrasound and the giant cell arteritis probability score for the diagnosis of giant cell arteritis: a Canadian single-centre experience |
title_full_unstemmed | Colour Doppler ultrasound and the giant cell arteritis probability score for the diagnosis of giant cell arteritis: a Canadian single-centre experience |
title_short | Colour Doppler ultrasound and the giant cell arteritis probability score for the diagnosis of giant cell arteritis: a Canadian single-centre experience |
title_sort | colour doppler ultrasound and the giant cell arteritis probability score for the diagnosis of giant cell arteritis: a canadian single-centre experience |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8633428/ https://www.ncbi.nlm.nih.gov/pubmed/34859177 http://dx.doi.org/10.1093/rap/rkab083 |
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