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Early Persistent Inflammatory Synovitis Assessment (EPISA) Score

Purpose: To evaluate a patient with the recent onset of synovitis using the Early Persistent Inflammatory Synovitis Assessment (EPISA) score of El Miedany et al.

Description

El Miedany et al developed a score for distinguishing a person with a persistent inflammatory synovitis/arthritis from a transitory one. This score can help to identify a patient who may benefit from more aggressive management. The authors are from Ain Shams University in Cairo, Egypt.


 

Parameters:

(1) duration of morning stiffness in minutes

(2) anti-CCP titer

(3) baseline Health Assessment Questionnaire (HAQ)

(4) HAQ at 3 months

 

percent change in HAQ at 3 months =

= ((HAQ at 3 months) - (baseline HAQ)) / (baseline HAQ) * 100%

anti-CCP Titer

Points

negative

0

positive

1

 

EPISA score =

= (minutes of morning stiffness) + (11 * (points for anti-CCP titer)) + (percent change in HAQ at 3 months) + 40

 

where:

• The regression coefficients for the logistic regression model was 0.145 for morning stiffness, 2.418 for anti-CCP titer, and 0.036 for percent change in HAQ at 3 months. The constant was not given.

 

Interpretation:

• The EPISA scores ranged from 6.7 to 611 in the study population.

• A score >= 121.5 was considered positive for early persistent inflammatory synovitis/arthritis.

 

Performance:

• The sensitivity of the score at the cutoff was 99% and the specificity 86% in the study population.

 


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Specialty

Objective

ICD-10