CONTEST Not Superior to PEST Questionnaire for Diagnosing Psoriatic Arthritis

psoriatic arthritis
psoriatic arthritis
The CONTEST questionnaire includes the most discriminative questions from the three existing questionnaires.

The Psoriasis Epidemiology Screening Tool (PEST) demonstrates similar efficacy in the diagnosis of psoriatic arthritis (PsA) compared with the new 8-item screening questionnaire (CONTEST), according to results published in the Journal of the European Academy of Dermatology and Venereology.

Individuals with psoriasis — but not PsA — who completed the two questionnaires underwent a physical examination and were evaluated for function and quality of life. Patients with suspected PsA were compared with patients without PsA. The area under the receiving operating curve (AUC), along with sensitivity and specificity of previously published cutoffs, was used to compare the performance of CONTEST vs PEST in these patients.

Of a total of 451 dermatology patients across the four participating centers, 35% (159 of 451) were reviewed and 17% (27 of 159) had unidentified PsA (95% CI, 12.3-21.7). The mean patient age at diagnosis of psoriasis was 29.

When the PEST and CONTEST screening tools were compared, the sensitivity and specificity of PEST were found to be 0.60 (95% CI, 0.42-0.78) and 0.76 (95% CI, 0.69-0.83), respectively. With CONTEST, the sensitivity and specificity were 0.53 (95% CI, 0.34-0.72) and 0.71 (95% CI, 0.63-0.79), respectively. There was overlapping of the confidence limits for the AUC (AUC for PEST: 0.72; 95% CI, 0.61-0.84 and AUC for CONTEST: 0.66; 95% CI, 0.54-0.77).

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The investigators concluded that the PEST and CONTEST questionnaires performed equally well with respect to assessing the possible presence of PsA in patients with psoriasis, with no superiority observed with the more comprehensive CONTEST tool over the PEST screening tool.


Coates LC, Savage LJ, Chinoy H, et al. Assessment of two screening tools to identify psoriatic arthritis in patients with psoriasis [published online March 26, 2018]. J Eur Acad Dermatol Venereol. doi:10.1111/jdv.14971