Detection of Psoriatic Arthritis
Module 3 Discussion Post
One of the articles I selected to address my PICOT question, “Among adult patients presenting with Psoriatic Arthritis symptoms (P), does the use of Psoriasis Epidemiology Screening Tool (PEST) (I), compared to the use of standard diagnostic practices (C), lead to a reduction in time to diagnosis of PsA (O), within six months (T)?” is a study on whether the Psoriasis Epidemiology Screening Tool (PEST) is useful for the detection of Psoriatic Arthritis (PsA) by Setoyoma et al. (2021). The study was conducted over three years and two months, as patient data was collected from July 2017- September 2020. Setomaya et al. (2021) found that using the PEST questionnaire effectively diagnoses and identifies PsA among diverse psoriasis patients. This post will discuss how the study can be replicated in my institution, identifying the population matching, intervention, baseline data collection, expected outcomes, and evaluation plan. Detection of Psoriatic Arthritis
The study evaluated 143 Japanese patients with psoriasis to assess the utility of PEST in identifying PsA. My institution’s population shares similarities, as it includes diverse psoriasis patients managed by the dermatology and rheumatology teams. However, our population may vary demographically in characteristics such as ethnicity and lifestyle factors. The focus will remain on adult patients diagnosed with psoriasis, emphasizing those at risk for developing PsA. The intervention will be implementing the PEST questionnaire as a routine screening tool for all psoriasis patients during dermatology consultations. We will incorporate the tool into our electronic medical record system and provide training sessions for dermatologists and clinical staff to ensure appropriate administration and interpretation.
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Baseline data collection is vital for enhancing the success of implementing the intervention in the institution. The data will be extracted from the medical records and include the psoriasis patient’s demographics, lab results, and imaging records. Pre-intervention data on PsA diagnosis rates and diagnostic delays will also be collected. PsA diagnosis will be confirmed using the CAPSAR criteria. The primary expected outcome is reducing diagnostic delays for PsA through earlier identification. The implementation plan to replicate the study in my institution will be as follows; Detection of Psoriatic Arthritis
Who- The dermatology and rheumatology departments will collaborate to implement and monitor the intervention.
What- The PEST questionnaire responses, referral patterns in confirmed cases, and PsA confirmation rates will be reviewed monthly.
When—Baseline data will be collected over three months, followed by a six-month implementation phase, with quarterly evaluations thereafter.
Where- Outpatient dermatology and rheumatology clinics.
How- Comparing pre- and post-intervention diagnostic metrics using statistical methods, such as sensitivity and specificity calculations to assess PEST’s performance compared to baseline PsA diagnostic practices.
Replicating the article’s intervention could significantly improve PsA diagnostic timelines in my institution, aligning with the study’s findings of the PEST tool’s high sensitivity and specificity. Leveraging routine screening and multidisciplinary collaboration, we aim to enhance patient outcomes and promote earlier intervention for PsA. Moreover, this approach will contribute valuable data to the growing evidence of PEST’s utility in diverse populations. Detection of Psoriatic Arthritis
Reference
Setoyama, A., Sawada, Y., Saito-Sasaki, N., Ohmori, S., Omoto, D., Yamamoto, K., Yoshioka, H., Okada, E. & Nakamura, M. (2021). Psoriasis epidemiology screening tool (PEST) is useful for the detection of psoriatic arthritis in the Japanese population. Scientific Reports, 11(1), 16146. https://doi.org/10.1038/s41598-021-95620-4 Detection of Psoriatic Arthritis
