Diagnostic performance of the Bengali version of inflammatory back pain criteria in patients with axial spondylarthritis: a case control study

Mohammad Imtiaz Sultan; Mohammad Kafil Uddin Chowdhery; M. Toufiqul Islam; Ananya Bhattacharjee

doi:10.18203/2320-6012.ijrms20260254

Authors

Mohammad Imtiaz Sultan Department of Rheumatology, Kurmitola General Hospital, Dhaka, Bangladesh
Mohammad Kafil Uddin Chowdhery Department of Rheumatology, Kurmitola General Hospital, Dhaka, Bangladesh
M. Toufiqul Islam Department of Biochemistry, Chittagong Medical College Hospital, Chittagong, Bangladesh
Ananya Bhattacharjee Department of Medicine, BIRDEM General Hospital, Shahbagh, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2320-6012.ijrms20260254

Keywords:

Axial spondyloarthritis, Bengali version, Diagnostic accuracy, Inflammatory back pain, Sensitivity and specificity, Screening criteria

Abstract

Background: Axial Spondyloarthritis (axSpA) is a chronic inflammatory disease affecting the spine, which requires accurate and early diagnosis for effective management. Inflammatory back pain (IBP) is a key symptom of axSpA. While several diagnostic criteria sets for IBP exist, limited data is available on the Bengali version of these criteria. This study aimed to evaluate the diagnostic performance of the Bengali version of IBP criteria sets (Calin, Berlin set 8a, Berlin set 7b and ASAS) in patients with axSpA and mechanical back pain (MBP).

Methods: A total of 100 participants (50 axSpA patients and 50 MBP controls) were enrolled between April 2019 and September 2019 at Chattogram Medical College Hospital. Sensitivity, specificity, positive and negative predictive values and likelihood ratios were calculated for each IBP criteria set. ROC curve analysis was performed to assess overall diagnostic accuracy.

Results: The sensitivity of the Bengali Calin criteria was 88.4%, with a specificity of 78.9%. Berlin set 8a criteria demonstrated the highest sensitivity (92.3%) but lower specificity (77.0%). ASAS IBP criteria performed moderately with 78.0% sensitivity and 69.5% specificity.

Conclusions: The Bengali version of IBP criteria sets demonstrated strong diagnostic performance, with Berlin set 8a showing the highest sensitivity. These tools can aid in the early detection of axSpA in clinical settings in Bangladesh. Future research should focus on validating these criteria in larger, diverse populations.

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References

Braun J, Sieper J. Ankylosing spondylitis. Lancet. 2007;369(9570):1379–1390. DOI: https://doi.org/10.1016/S0140-6736(07)60635-7

Rudwaleit M, van der Heijde D, Khan MA, Braun J, Sieper J. How to diagnose axial spondyloarthritis early. Ann Rheum Dis. 2004;63(5):535–543. DOI: https://doi.org/10.1136/ard.2003.011247

Braun J, Inman RD. Clinical significance of inflammatory back pain for diagnosis and screening of patients with axial spondyloarthritis. Ann Rheum Dis. 2010;69(7):1264–1268. DOI: https://doi.org/10.1136/ard.2010.130559

Calin A, Porta J, Fries JF, Schurman DJ. Clinical history as a screening test for ankylosing spondylitis. JAMA. 1977;237(24):2613–2614. DOI: https://doi.org/10.1001/jama.1977.03270510035017

Rudwaleit M, Metter A, Listing J, Sieper J, Braun J. Inflammatory back pain in ankylosing spondylitis: a reassessment of the clinical history. Arthritis Rheum. 2006;54(2):569–578. DOI: https://doi.org/10.1002/art.21619

Sieper J, van der Heijde D, Landewe R. New criteria for inflammatory back pain in patients with chronic back pain (ASAS). Ann Rheum Dis. 2009;68:784–788. DOI: https://doi.org/10.1136/ard.2008.101501

Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine. 2000;25(24):3186–3191.

Solmaz D, Akar S, Gunduz O. Performance of different criteria sets for inflammatory back pain in patients with axial spondyloarthritis. Arthritis Rheumatol. 2014;62(10):544. DOI: https://doi.org/10.1007/s10067-014-2622-2

Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine. 2000;25(24):3186–3191. DOI: https://doi.org/10.1097/00007632-200012150-00014

Caroline Terwee CB, Bot SDM, de Boer MR. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60(1):34–42. DOI: https://doi.org/10.1016/j.jclinepi.2006.03.012

Amor, B., Dougados, M., Mijiyawa, M. Criteria of the classification of spondyloarthropathies. Rev Rhum Mal Osteoartic. 1990;57(5):85–9.

Taurog JD, Chhabra A, Colbert RA. Ankylosing spondylitis and axial spondyloarthritis, New England Journal of Medicine. 2016;374 2563-74. DOI: https://doi.org/10.1056/NEJMra1406182

Feldtkeller E, Lemmel E, Russell AS. Ankylosing spondylitis in the Pharaohs of ancient Egypt. Rheumatol Int. 2003;23(1):1-5. DOI: https://doi.org/10.1007/s00296-002-0242-7

Weisman MH, Chen L, Clegg DO. Development and validation of a case ascertainment tool for ankylosing spondylitis. Arthritis Care Res. 2010;62(1):19-27. DOI: https://doi.org/10.1002/acr.20009

Ryall, N., Helliwell, P. A Critical review of ankylosing spondylitis. Crit Rev Phys Rehabil Med. 1998;10(3):265-301. DOI: https://doi.org/10.1615/CritRevPhysRehabilMed.v10.i3.40

Said-Nahal R, Miceli-Richard C, Berthelot JM, Duche A, Dernis-Labous E, Blevec G, et al. ‘The familial form of spondylarthropathy: a clinical study of 115 multiplex families’. Arthr Rheumatol. 2000;43:1356–65. DOI: https://doi.org/10.1002/1529-0131(200006)43:6<1356::AID-ANR20>3.0.CO;2-Y