Protocol - Psoriatic Arthritis (PsA) - Screening
The Psoriasis Epidemiology Screening Tool (PEST) is a five-item, yes-or-no response, self-report questionnaire.
The Psoriasis Epidemiology Screening Tool (PEST) is a validated screening tool for psoriatic arthritis (PsA). It is recommended that patients with psoriasis who do not have a diagnosis of PsA complete an annual PEST questionnaire (NICE 2017). A score of 3 or more indicates referral to rheumatology should be considered. A “positive” PEST does not indicate that the patient has PsA as this questionnaire can also capture patients with other forms of inflammatory arthritis and/or fibromyalgia. This questionnaire has relatively high sensitivity (picks up most of the patients with PsA) but lower specificity (a positive screen does not mean that the patient has PsA).
Note: The PhenX Bone and Joint working group acknowledge that the protocol can be used with or without the diagram.
Please answer the questions below and score 1 point for each question answered ‘Yes’
|1, Have you ever had a swollen joint (or joints)?||[ ]||[ ]|
|2. Has a doctor ever told you that you have arthritis?||[ ]||[ ]|
|3. Do your finger nails or toenails have holes or pits?||[ ]||[ ]|
|4. Have you had pain in your heel?||[ ]||[ ]|
|5. Have you had a finger or toe that was completely swollen and painful for no apparent reason?||[ ]||[ ]|
A total score of 3 or more out of 5 is positive and indicates referral to rheumatology should be considered.
Personnel and Training Required
|Specialized requirements for biospecimen collection||No|
|Average time of greater than 15 minutes in an unaffected individual||No|
Mode of Administration
Adolescent, Adult, Senior
Adolescents and adults with psoriasis
The Psoriasis Epidemiology Screening Tool (PEST) is a validated screening tool for psoriatic arthritis (PsA). The National Institute for Health and Care Excellence (UK) recommended that patients with psoriasis who do not have a diagnosis of PsA complete an annual PEST questionnaire.
Chinese, English, Spanish
|caDSR Common Data Elements (CDE)||Psoriatic Arthritis (PsA) Screening||11136931||CDE Browser|
Process and Review
Protocol Name from Source
Psoriasis Epidemiology Screening Tool (PEST)
Ibrahim, G. H., Buch, M. H., Lawson, C., Waxman, R., & Helliwell, P. S. (2009). Evaluation of an existing screening tool for psoriatic arthritis in people with psoriasis and the development of a new instrument: The Psoriasis Epidemiology Screening Tool (PEST) questionnaire. Clinical and Experimental Rheumatology, 27(3), 469–474. PMID: 19604440.
Mease, P. J., Gladman, D. D., Papp, K. A., Khraishi, M. M., Thaci, D., Behrens, F., . . . Alvarez, D. (2013). Prevalence of rheumatologist-diagnosed psoriatic arthritis in patients with psoriasis in European/North American dermatology clinics. Journal of the American Academy of Dermatology, 69(5), 729–735. doi:10.1016/j.jaad.2013.07.023. PMID: 23981683.
National Institute for Health and Care Excellence (NICE). (2017). Psoriasis: Assessment and management. Clinical guideline [CG153]. Published: 24 October 2012. London: NICE.
|Variable Name||Variable ID||Variable Description||dbGaP Mapping|
|PX171801220000||Has a doctor ever told you that you have more||N/A|
|PX171801230000||Do your finger nails or toenails have holes more||N/A|
|PX171801250000||Have you had a finger or toe that was more||N/A|
|PX171801240000||Have you had pain in your heel?||N/A|
|PX171801210000||Have you ever had a swollen joint (or joints)?||N/A|
Psoriatic Arthritis (PsA) - Screening
October 21, 2022
This measure consists of a validated screening tool (questionnaire) for psoriatic arthritis (PsA).
One in three individuals with psoriasis have psoriatic arthritis (PsA). Consistent screening for PsA is key to ensuring individuals with psoriasis receive timely and appropriate clinical care and treatment.
psoriatic arthritis (psa) - screening, Psoriasis Epidemiology Screening Tool, PEST, bone and joint, British Association of Dermatologists, pain, National Institute for Health and Care Excellence, NICE
|Protocol ID||Protocol Name|
|171801||Psoriatic Arthritis (PsA) - Screening|
There are no publications listed for this protocol.