ArticleRMD open2020
Probability-based algorithm using ultrasound and additional tests for suspected GCA in a fast-track clinic.
Article in RMD open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 53 citations in OpenAlex.
- Article
- A Clinical Probability-Based, Stepwise Algorithm for the Diagnosis of Giant Cell Arteritis: Study Protocol and Baseline Characteristics of the First 50 Patients Included in the Prospective Validation Study with Focus on Cranial Symptoms.Journal of clinical medicine · 2025Article
- An innovative hybrid training method for ultrasound in giant cell arteritis, polymyalgia rheumatica and large vessel vasculitis.Australasian journal of ultrasound in medicine · 2025Article
- Multimodality imaging to assess diagnosis and evaluate complications of large vesselarteritis.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2024Review
- Diagnosing vasculitis with ultrasound: findings and pitfalls.Therapeutic advances in musculoskeletal disease · 2024Review
- Giant cell arteritis: reviewing the advancing diagnostics and management.Eye (London, England) · 2023Review
- Color Doppler Eye Ultrasonography in giant cell arteritis: differential diagnosis between arteritic and non-arteritic sudden blindness.Journal of ultrasound · 2023Article
- Validity of the EULAR recommendations on the use of ultrasound in the diagnosis of giant cell arteritis.RMD open · 2022Article
- Angiopoietin-2/-1 ratios and MMP-3 levels as an early warning sign for the presence of giant cell arteritis in patients with polymyalgia rheumatica.Arthritis research & therapy · 2022Article
- Performance of the Southend pre-test probability score (PTPS) for giant cell arteritis in a fast-track clinic in Western Australia.Rheumatology advances in practice · 2022Article
- Validation of the Southend giant cell arteritis probability score in a Scottish single-centre fast-track pathway.Rheumatology advances in practice · 2022Article
- Tocilizumab for the treatment of giant cell arteritis in Scotland: a report on behalf of the Scottish Society for Rheumatology standards subgroup.Rheumatology advances in practice · 2022Article
- Comment on: Validation of the Southend giant cell arteritis probability score in a Scottish single-centre fast-track pathway. Reply.Rheumatology advances in practice · 2022Article
- Comment on: Validation of the Southend giant cell arteritis probability score in a Scottish single-centre fast-track pathway.Rheumatology advances in practice · 2022Article
- Evolution of ultrasound in giant cell arteritis.Frontiers in medicine · 2022Review
- Current developments in the diagnosis and treatment of giant cell arteritis.Frontiers in medicine · 2022Review
- Imaging Tests in the Early Diagnosis of Giant Cell Arteritis.Journal of clinical medicine · 2021Review
- A Diagnostic Algorithm Based on a Simple Clinical Prediction Rule for the Diagnosis of Cranial Giant Cell Arteritis.Journal of clinical medicine · 2021Article
- Role of the halo sign in the assessment of giant cell arteritis: a systematic review and meta-analysis.Rheumatology advances in practice · 2021Article
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Authors and funding
6 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesClinical presentations of giant cell arteritis (GCA) are protean, and it is vital to make a secure diagnosis and exclude mimics for urgent referrals with suspected GCA. The main objective was to develop a joined-up, end-to-end, fast-track confirmatory/exclusionary, algorithmic process based on a probability score triage to drive subsequent investigations with ultrasound (US) and any appropriate additional tests as required.
methodsThe algorithm was initiated by stratifying patients to low-risk category (LRC), intermediate-risk category (IRC) and high-risk category (HRC). Retrospective data was extracted from case records. The Southend pretest probability score (PTPS) overall showed a median score of 9 and a 75th percentile score of 12. We, therefore, classified LRC as PTPS <9, IRC 9-12 and HRC >12. GCA diagnosis was made by a combination of clinical, US, and laboratory findings. The algorithm was assessed in all referrals seen in 2018-2019 to test the diagnostic performance of US overall and in individual categories.
resultsOf 354 referrals, 89 had GCA with cases categorised as LRC (151), IRC (137) and HRC (66). 250 had US, whereas 104 did not (score <7, and/or high probability of alternative diagnoses). In HRC, US showed sensitivity 94%, specificity 85%, accuracy 92% and GCA prevalence 80%. In LRC, US showed sensitivity undefined (0/0), specificity 98%, accuracy 98% and GCA prevalence 0%. In IRC, US showed sensitivity 100%, specificity 97%, accuracy 98% and GCA prevalence 26%. In the total population, US showed sensitivity 97%, specificity 97% and accuracy 97%. Prevalence of GCA overall was 25%.
conclusionsThe Southend PTPS successfully stratifies fast-track clinic referrals and excludes mimics. The algorithm interprets US in context, clarifies a diagnostic approach and identifies uncertainty, need for re-evaluation and alternative tests. Test performance of US is significantly enhanced with PTPS.
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