For a study, researchers sought to assess the agreement between senior rheumatologists’ diagnoses and those of rheumatology residents, general practitioners (GPs), and other healthcare professionals.
A second-year rheumatology resident conducted the first evaluation of 497 individuals in the cohort who had been referred by general practitioners between August 1, 2018, and December 16, 2019. Following clinical rounds, the diagnoses provided by senior rheumatologists were taken as the gold standard for defining the prevalence of the rheumatic diseases, which were divided into 5 groups: rheumatoid arthritis, spondyloarthritis, other connective tissue diseases and vasculitis, nonautoimmune rheumatic diseases, and nonrheumatic diseases. November 30, 2020, marked the conclusion of the follow-up. For the diagnosis made by GPs and residents, they assessed the sensitivity, specificity, positive predictive value, negative predictive value, and coefficient.
In 58% of the referral letters, the diagnoses were modified. For 50% of the diagnoses, simple diseases like osteoarthritis and fibromyalgia were to blame. Residents in rheumatology performed better than senior rheumatologists with κ > 0.6 in every category, with a nonautoimmune rheumatic disease (κ= -0.18) and nonrheumatic disease (κ = 0.15). GPs performed worse than residents in every category with κ < 0.5. A total of 46% of the letters were improperly complicated in terms of level.
Between GPs and the rheumatology team, they discovered a low degree of diagnostic agreement. Rheumatic disease diagnosis and treatment became challenging for general practitioners, who consequently referred patients who needed to get primary care. Residents’ abilities in rheumatology were on par with those of senior rheumatologists after just one year of training.