3/11/2026
A study published in Rheumatology Advances in Practice evaluated a new online screening tool, A-Tool©, designed to help people with chronic back pain determine whether they should be referred to a rheumatologist for possible axial spondyloarthritis (axSpA).
The A-Tool, developed by Dr. Abhijeet Danve at Yale School of Medicine, focuses on well-established clinical features of axSpA such as inflammatory back pain patterns, peripheral arthritis, uveitis, psoriasis, and family history of spondyloarthritis. Designed to be simple, low-cost, and patient-friendly, the tool can be completed independently or administered by healthcare providers, without requiring lab tests or imaging prior to referral.
To test the effectiveness of the A-Tool, Dr. Danve and his team conducted a prospective study of patients with chronic back pain. Between April 2019 and February 2022, 1,274 patients completed the A-Tool—roughly half via a Facebook page run by the Yale Center for Clinical Investigation, and half through the MyChart patient portal of the EPIC electronic medical record system. Of these, 507 (40%) had a positive A-Tool result. Patients with a confirmed diagnosis of spondyloarthritis or an obvious alternative cause of back pain were excluded. From the remaining pool, 100 patients were enrolled—39 via social media and 61 via MyChart outreach—for in-person evaluation.
Eighty-six participants completed all study procedures, including a rheumatology visit, labs, and imaging. Among these, 29 (34%) were diagnosed with axSpA, including seven with ankylosing spondylitis and 22 with non-radiographic axSpA. The remaining 54 patients were diagnosed as having no axSpA, and three were considered uncertain. Investigators rated 19 of the axSpA cases as “definite” and 10 as “probable.”
The study demonstrated that the A-Tool is practical, feasible, and scalable for self-referral, allowing patients to complete it independently without prior labs or imaging. Recruitment through both patient portals and social media confirmed that such tools can reach a wide audience and help guide patients to specialist care.
While this was a pilot study with a relatively small number of fully evaluated patients, the A-Tool shows promise for earlier identification of axSpA, potentially enabling timely treatment and improved outcomes.
The A-Tool is now available on SAA’s website on the page “Could Your Chronic Back Pain Be Caused by Spondyloarthritis?”, which serves as a hub of information for people with undiagnosed chronic back pain. Its easy online accessibility allows individuals to assess their symptoms, consider a rheumatology referral, and learn more about spondyloarthritis from trusted sources.
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