Arthritis News - 1999
In a recent study from Edmonton, Canada (Br J Rheumatol 37:1215-9, 1998), Gamez-Nava et al evaluated the primary care patterns of referral and rheumatological diagnoses of consecutive patients referred to two university-based rheumatologists in 1994. 347 (49%) of the patients referred to the rheumatologists were diagnosed by their primary care physicians with a defined rheumatic disease (other than soft tissue pain syndromes). Of these, 142 (41%) of the primary care diagnoses were subsequently modified by the rheumatologist. The highest agreement between primary care physician and rheumatologist was observed for crystal-induced arthritis (kapa=0.86), and the lowest agreement for polymyalgia rheumatica (kapa=0.39). Positive predictive values were low, especially for systemic lupus erythematosus (33%) and polymyalgia rheumatica (30%).
The authors concluded that diagnostic agreement between rheumatologists and primary care physicians was low.