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Clinical Trial
. 2025 Apr 28;45(5):129.
doi: 10.1007/s00296-025-05861-z.

RhePort 1.3 enhances early identification of inflammatory rheumatic diseases: a prospective study in German rheumatology settings

Cay-Benedict von der Decken  1   2   3   4 , Stefan Kleinert  5   6   7 , Matthias Englbrecht  8 , Kirsten Karberg  5   9 , Georg Gauler  5   10 , Monika Ronneberger  7 , Praxedis Rapp  7 , Florian Schuch  7 , Joerg Wendler  7 , Susanna Späthling-Mestekemper  5   11 , Christoph Kuhn  5   12 , Wolfgang Vorbrüggen  5   13 , Martin Welcker  5   14 , Peter Bartz-Bazzanella  5   15   13
Affiliations
Clinical Trial

RhePort 1.3 enhances early identification of inflammatory rheumatic diseases: a prospective study in German rheumatology settings

Cay-Benedict von der Decken et al. Rheumatol Int. .

Abstract

More efficient means of identifying patients with inflammatory rheumatic diseases (IRDs) could allow earlier diagnosis and treatment. The objective of this study was to evaluate the characteristics of a revised version of an online patient questionnaire-based self-referral tool, RhePort 1.3. This prospective study included adult patients with musculoskeletal complaints presenting for a first rheumatology visit at German RheumaDatenRhePort (RHADAR) rheumatology network centers. All patients completed the RhePort 1.3 questionnaire on patient characteristics and symptoms. Data from RhePort 1.3 were compared with historical data from previous versions. Of 614 patients, 225 (36.6%) were diagnosed with an IRD by a rheumatologist and 164/225 IRD patients (72.9%) had a RhePort 1.3 score > 1, the cut-off point used to determine the need for rheumatologic evaluation. A score > 1 was associated with an approximately two-fold higher IRD risk (odds ratio [95% confidence interval] of 1.98 [1.39, 2.83] vs ≤ 1) and had good sensitivity (73%) and moderate specificity (42%). Among patients referred through a standard referral pathway (n = 283), RhePort 1.3 scores > 1 in addition to physician referral were associated with increases in rheumatology-diagnosed IRD rates from 33.2% (physician referral only) to 45.7%. RhePort 1.3 had higher accuracy than earlier versions (54% vs 35%). We conclude that modest changes to the RhePort questionnaire resulted in increased accuracy. A score > 1 was associated with a doubled risk for an IRD and higher IRD rates in physician-referred patients. These data suggest that RhePort has the potential to streamline the rheumatologist's workload and improve resource use. Further modifications are required to improve specificity.

Keywords: Online system; Referral and consultation; Rheumatic diseases; Rheumatology; Surveys and questionnaires; Workload.

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Conflict of interest statement

Declarations. Conflict of interest: C-BvdD received travel/meeting support from AbbVie and Galapagos/Alpha sigma. SK received grants from AbbVie, Novartis, and Sparrow, and consulting and/or speaker’s fees from AbbVie, Celgene, Chugai, Galapagos, Novartis, and Siemens Healthineers. ME received funding for the present study for data analysis from RHADAR GbR and also received consulting fees from AbbVie and RHADAR, speaker’s fees from AbbVie, Janssen-Cilag, Sanofi, and Swedish Orphan Biovitrum, and is on the advisory board of Chugai Pharma Germany. KK received speaker’s fees from AbbVie, Galapagos, Novartis, Rheumakademie, and UCB and travel/meeting support from UCB. GG received speaker’s fees from AbbVie, Galapagos, and Novartis and travel/meeting support from AbbVie and Novartis. JW received consulting and/or speaker’s fees from AbbVie, Janssen-Cilag, and Novartis. SS-M received speakers fees from AbbVie, Boehringer Ingelheim, Eli Lilly, GSK, Janssen-Cilag, Novartis, and UCB. MW received consulting and/or speaker’s fees from AbbVie, Fresenius, Galapagos, Lilly, and UCB and travel/meeting support from AbbVie, Galapagos, GSK, Lilly, and UCB. PB-B received speaker’s fees from AbbVie, Boehringer Ingelheim, Chugai/Roche, Janssen-Cilag, Novartis, Pfizer, and UCB and travel/meeting support from AbbVie. MR, PR, FS, CK, and WV have no conflicts of interest to disclose. C-BvdD, SK, KK, GG, SS-M, CK, WV, MW, and PB-B are members of RheumaDatenRhePort (RHADAR) GbR. Ethical approval Ethical approval for this study was obtained from the Ethics Committee of Ärztekammer Nordrhein (number 2021387; November 11, 2021) and the study was conducted in compliance with the Declaration of Helsinki. All patients enrolled in the study provided written informed consent.

Figures

Fig. 1
Fig. 1
Percentages of patients with specific IRD diagnoses among patients with IRDs (n = 225). ANCA antineutrophil cytoplasmic antibody, axSpA axial spondyloarthritis, CiA crystal-induced arthropathy, GCA giant cell arteritis, IRD inflammatory rheumatologic disorder, PMR polymyalgia rheumatica, PsA psoriatic arthritis, RA rheumatoid arthritis, SLE systemic lupus erythematosus, UA undifferentiated arthritis
Fig. 2
Fig. 2
RhePort 1.3 scores in patients a with an IRD diagnosis or b with a diagnosis of no IRD. IRD inflammatory rheumatologic disorder
Fig. 3
Fig. 3
Box and whisker plot of distribution of RhePort 1.3 score by IRD diagnosis. Boxes illustrate the upper quartile, median (center line), and lower quartile values. Vertical lines represent minimum and maximum values. axSpA axial spondyloarthritis, CiA crystal-induced arthropathy, IRD inflammatory rheumatologic disorder, PMR polymyalgia rheumatica, PsA psoriatic arthritis, RA rheumatoid arthritis, UA undifferentiated arthritis
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