The GALS musculoskeletal exam can be used by family physicians and nurse practitioners to screen for signs and symptoms of rheumatoid arthritis

Arthritis Care & Research , 05/25/2012

Beattie KA et al. – Following a very short training period, family physicians and nurse practitioners appear to be able to employ the GALS exam as a screening tool for RA signs and symptoms – particularly for identifying an individual with positive results who will benefit from further investigation or rheumatology referral.

Methods

  • Participating healthcare professionals, including two rheumatologists, three family physicians and three nurse practitioners, were trained to perform the GALS exam by viewing an instructional DVD and attending a training workshop.
  • One week after training, healthcare professionals performed the GALS exam on 20 individuals with rheumatoid arthritis and 21 individuals without rheumatoid arthritis.
  • All participants were recruited through two rheumatology practices.
  • Each participant was assessed by four healthcare professionals.
  • Healthcare professionals were asked to record whether observed signs and symptoms were potentially consistent with a diagnosis of rheumatoid arthritis.
  • Healthcare professionals understood the study's objective to be their agreement on GALS findings amongst one another and were unaware that half the participants had rheumatoid arthritis.
  • Sensitivity and specificity were calculated to determine the ability of the GALS examination to screen for rheumatoid arthritis using the rheumatologist as the standard for comparison.

Results

  • For the 3 family physicians, sensitivity values varied from 60–100% and specificity values varied from 70–82%.
  • For the 3 nurse practitioners, sensitivity values varied from 60–90% and specificity values varied from 73–100%.

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