Document Server@UHasselt >
Research >
Research publications >

Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/2633

Title: Psoriatic arthritis: performance of rheumatologists in daily practice
Authors: Gorter, S
van der Linden, S
Houben, H
Rethans, JJ
Scherpbier, AJJA
van der Vleuten, CPM
Issue Date: 2002
Citation: ANNALS OF THE RHEUMATIC DISEASES, 61(3). p. 219-224
Abstract: Objectives: To assess, using standardised patients (SPs), how rheumatologists diagnose psoriatic arthritis, whether the diagnostic efficiency is influenced by specific characteristics of the rheumatologists, and to study the relationship with costs. Methods: Twenty three rheumatologists were each visited by one of two SPs (one male, one female) presenting as a patient with psoriatic arthritis. SPs remained incognito for all meetings for the duration of the study. Immediately after the encounter, SPs completed case-specific checklists on the medical content of the encounter. Information on ordered laboratory and imaging tests was obtained from each hospital. Results: Fourteen rheumatologists diagnosed psoriatic arthritis correctly. They inspected the skin for psoriatic lesions more often than those rheumatologists who established other diagnoses. Rheumatologists diagnosing psoriatic arthritis spent more on additional laboratory and imaging investigations. These were carried out after the diagnosis to confirm it and to record the extent and severity of the disease. No differences in type of practice, number of outpatients seen each week, working experience, or sex were found between rheumatologists who made the correct diagnosis and those who made other g diagnoses. The correct diagnosis was more often missed by rheumatologists who saw the male SP, who presented with clear distal interphalangeal DIP joint arthritis only, causing confusion with osteoarthritis of the DIP joints. Conclusion: There is a considerable amount of variation in the delivery of care among rheumatologists who see an SP with psoriatic arthritis. Rheumatologists focusing too much on the most prominent features (DIP joint arthritis) sometimes seem to forget "the hidden (skin) symptoms".
Notes: Univ Hosp Maastricht, Dept Internal Med, Div Rheumatol, NL-6202 AZ Maastricht, Netherlands. Atrium Med Ctr, Heerlen, Netherlands. Maastricht Univ, Fac Med, Maastricht, Netherlands. Limburgs Univ Centrum, Diepenbeek, Belgium.van der Heijde, DMFM, Univ Hosp Maastricht, Dept Internal Med, Div Rheumatol, POB 5800, NL-6202 AZ Maastricht, Netherlands.
URI: http://hdl.handle.net/1942/2633
DOI: 10.1136/ard.61.3.219
ISI #: 000173984400008
ISSN: 0003-4967
Category: A1
Type: Journal Contribution
Validation: ecoom, 2003
Appears in Collections: Research publications

Files in This Item:

There are no files associated with this item.

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.