title: Rate of Proven Rheumatic Diseases in a Large Collective of Referrals to an Outpatient Rheumatology Clinic Under Routine Conditions.
abstract: The prognostic significance of early diagnosis and therapeutic intervention in inflammatory rheumatic diseases has been well documented. However, a shortage of rheumatologists often impedes this approach in clinical practice. Therefore, it is of importance to identify those patients referred for diagnosis who would benefit most from a specialist's care. We applied a telephone-based triage for appointment allocation during routine care. This retrospective, monocentric analysis evaluated the efficacy of our triage to identify patients with rheumatic disease with special regard to initial appointment category (elective, early arthritis clinic (EAC), or emergency appointment). Of the 1,782 patients assessed, 718 (40.3%) presented with an inflammatory rheumatic disease, and there were significant discrepancies between the appointment categories: elective 26.2%, EAC 49.2% (P< 0.001) and emergency appointment 56.6% (P< 0.001). We found that 61.2% of patients were allocated to the correct diagnostic category (inflammatory or noninflammatory) solely based on the telephone-based triage and 67.1% based on the combination of triage and C-reactive protein (CRP) count.
authors.affiliation: Rheumatology and Clinical Immunology, Medizinische Klinik II, Kreiskliniken Altötting-Burghausen, Burghausen, Germany.; Zentrum für Innere Medizin, Medizinische Klinik und Poliklinik II, University of Würzburg, Würzburg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Feuchtenberger
authors.affiliation: Rheumatology and Clinical Immunology, Medizinische Klinik II, Kreiskliniken Altötting-Burghausen, Burghausen, Germany.
authors.forename: Axel Philipp
authors.initials: AP
authors.lastname: Nigg
authors.affiliation: Zentrum für Innere Medizin, Medizinische Klinik und Poliklinik II, University of Würzburg, Würzburg, Germany.; Gastroenterology and Hepatology, Medizinische Klinik II, Kreiskliniken Altötting-Burghausen, Burghausen, Germany.
authors.forename: Michael Rupert
authors.initials: MR
authors.lastname: Kraus
authors.affiliation: Zentrum für Innere Medizin, Medizinische Klinik und Poliklinik II, University of Würzburg, Würzburg, Germany.; Diabetes Zentrum Mergentheim, Bad Mergentheim, Germany.
authors.forename: Arne
authors.initials: A
authors.lastname: Schäfer
keywords: early arthritis clinic; referral; rheumatic disease; triage