E026 Evaluating the integration and use of the Southend Giant Cell Arteritis Probability Score and temporal artery ultrasound in the initial triage and assessment of patients with giant cell arteritis in the Aneurin Bevan University Health Board

Abstract Background/Aims Early diagnosis is essential in preventing irreversible visual impairment in patients with giant cell arteritis (GCA). However, unnecessary treatment in patients without definite GCA can also lead to steroid-related complications and adverse events. The British Society for Rheumatology guidelines recommend the use of temporal artery ultrasound scans (TAUSS) as a non-invasive diagnostic test to confirm GCA. The Southend Giant Cell Arteritis Probability Score (GCAPS) is a clinical probability scoring tool used to stratify the risk in suspected patients, with a score of 9 as low risk, 9-12 intermediate and 12 high risk. Rheumatology services across Aneurin Bevan University Health Board (ABUHB) have developed a triage pathway integrating the use of GCAPS for the initial triaging of referrals. Intermediate and high-risk cases are recommended to proceed to TAUSS. We aimed to assess the impact of the new pathway and analyse the correlation between GCAPS, TAUSS and the final clinical diagnosis in those with suspected GCA. Methods Retrospective data were collected over a 6-month period, with the data extracted for TAUSS requests from rheumatology referrals between July 2024 and January 2025. A total of 37 patients were included for analysis in this project. The data were collected via a questionnaire, consisting of questions on demographics, co-morbidities, initial presenting complaint, calculation of GCAPS at triage, time from initial referral to triage and review in rheumatology services. We reviewed the correlation of GCAPS and TAUSS results with the final clinician diagnosis. Results The majority of patients were female (73%) at age 65 (76%). Headache was the most frequent presenting complaint (63%). 76% of referrals had calculated GCAPS. 4 cases were low risk, of which two had positive GCA USS findings. 12 cases were medium risk, of which all had a normal USS. 12 cases were high risk, of which 5 had USS features consistent with GCA, 6 were normal and 1 equivocal scan. 9 cases did not have GCAPS calculated, 8 patients had a normal scan, with 1 having findings consistent with GCA. Overall, USS findings correlated with the final clinical diagnosis in 32% of cases. Conclusion Timely triage of referrals with the use of GCAPS and TAUSS assisted in early assessment of patients with suspected GCA. GCAPS is a useful tool for risk stratification but must be interpreted with caution. As in this case, there is a risk of missing cases if solely relying on GCAPS. It is important to have an accurate history in order to assist in the risk stratification process and also to ensure accurate calculations of the GCAPS. USS findings are also impacted by steroids and can impact the sensitivity of scans, possibly explaining the correlation between the scans and the final diagnosis. Disclosure G. Dosanjh: None. N. Cernovschi-Feasey: None. M. Shivaraj: None. R. Asif: None. E. Thomas: None.