Evaluating the diagnostic accuracy of a screening questionnaire for detecting hidradenitis suppurativa: a pooled analysis of accuracy measures from the global hidradenitis suppurativa atlas (GHiSA) study

Bouazzi, Dorra, Lophaven, Søren, Hagan, Paa Gyasi, Botvid, Sofia, Hove, Lone Storgaard, Prens, Errol P., Knecht-Gurwin, Klaudia, Szepietowski, Jacek C., Anaba, Ehiaghe L., Chehad, Ahmed Samaouel, Zobiri, Samira, Serradj, Amina, Bhuiyan, Mohammed Saiful Islam, Noor, Towhida, Guillem, Philippe, Parvizi, Mohammad Mahdi, Saki, Nasrin, Alpsoy, Erkan, Vardar, Caner, Kanni, Theodora, Giamarellos-Bourboulis, Evangelos J., Frew, John W, Maharbi, Waleed Hamed Ali A., van Huijstee, Johanna C., Aarts, Pim, Dewi, Shinta Trilaksmi, Febriana, Sri Awalia, Indrastuti, Niken, Suryawati, Nyoman, Pangastuti, Miranti, Adji, Aryani, Akhyar, Gardenia, And, Nopriyati, Hazlianda, Cut Putri, Reyes-Baraona, Francisco, Matas, Carlos, Saeed, Haroon, Moodley, Ameshin, Binamer, Yousef, Kamil, Moonyza Akmal Ahmad, Jocic, Ivana, Mijuskovic, Zeljko, Mallawaarachchi, Kanchana, Gangani, Chathurika, Tusheva, Ivana, Boshkovski, Vesna Brishkoska, Danchen, Hu, Songmei, Geng, Medianfar, Cecilia E., Saunte, Ditte M. L., Chandran, Nisha S., Van Der Zee, Hessel H, Zouboulis, Christos C., Benhadou, Farida, Villumsen, Bente, Alavi, Afsaneh, Ibekwe, Perpetua U., Hamzavi, Iltefat H., Ingram, John R. ORCID: https://orcid.org/0000-0002-5257-1142, Naik, Haley B., Garg, Amit, Boer, Jurr, Christensen, Robin and Jemec, Gregor B. E. 2026. Evaluating the diagnostic accuracy of a screening questionnaire for detecting hidradenitis suppurativa: a pooled analysis of accuracy measures from the global hidradenitis suppurativa atlas (GHiSA) study. British Journal of Dermatology , ljag005. 10.1093/bjd/ljag005

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Abstract

Background Hidradenitis Suppurativa (HS) is a devastating inflammatory skin disease with a prolonged diagnostic delay of approximately 7-10 years. The diagnostic delay can be attributed to varying factors, including low awareness of diagnostic criteria among non-dermatologic healthcare professionals often leading to misdiagnosis. Screening questionnaires have been proposed for the diagnosis of HS, and one of such has been validated and used in the Global Hidradenitis Suppurativa Atlas (GHiSA) Global Prevalence Study (GPS). Objective To evaluate and provide a summary of the diagnostic accuracy measures (pooled sensitivity and specificity) of the screening questionnaire employed in the GHiSA GPS. Methods and Materials All studies that adhered to the GHiSA methodology and provided diagnostic accuracy data were eligible for inclusion. The data was extracted from the eligible studies and typed into an excel sheet twice by two authors. Data on geographical location and diagnostic accuracy parameters (true positive, false positive, true negative and false negative) were extracted from the included studies. The quality of the included studies were assessed using the quality assessment of diagnostic accuracy studies tool (QUADAS-2). Results Data from 25 studies (23 countries) were included in the pooled analysis. The QUADAS-2 assessment revealed high risk of bias in the domains “reference standard” and “patient flow”. For applicability, there were concerns for “patient selection”. Substantial variations in sensitivity (0.43– 1.00) and specificity (0.15 -1.00) values were observed globally. The bivariate random effects model showed a pooled sensitivity of 0.88 (95%CI; 0.80 to 0.94) and a pooled specificity of 0.86 (95%CI; 0.78 to 0.91). The summary operating receiver curve (sROC) revealed a clustering of studies in the upper left corner, indicating a sensitivity and specificity close to one. The area under the curve (AUC) was 0.93, suggesting excellent accuracy. Conclusion Despite substantial variations in the diagnostic estimates across the globe, the pooled analysis indicated that the accuracy was excellent for the GHiSA screening questionnaire. The screening questionnaire may prove useful in triaging, ensuring that only individuals fitting the criteria see specialized dermatological care.

Item Type:	Article
Date Type:	Published Online
Status:	In Press
Schools:	Schools > Medicine
Additional Information:	License information from Publisher: LICENSE 1: URL: https://academic.oup.com/pages/standard-publication-reuse-rights, Start Date: 2026-01-09 RRS policy applied 23/01/2026 AB
Publisher:	Oxford University Press
ISSN:	0007-0963
Date of First Compliant Deposit:	23 January 2026
Date of Acceptance:	29 December 2025
Last Modified:	23 Jan 2026 12:30
URI:	https://orca.cardiff.ac.uk/id/eprint/184141

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