Do we need to lower the cut point of the 2010 ACR/EULAR classification criteria for diagnosing rheumatoid arthritis?

被引：4

作者：

van der Ven, Myrthe ^{[1
]}

Alves, Celina ^{[1
]}

Luime, Jolanda J. ^{[1
]}

Gerards, Andreas H. ^{[2
]}

Barendregt, Pieternella J. ^{[3
]}

van Zeben, Derkjen ^{[4
]}

van Schaeybroeck, Barbara ^{[5
]}

de Sonnaville, Peter B. J. ^{[6
]}

Grillet, Bernard A. ^{[7
]}

Hazes, Johanna M. W. ^{[1
]}

机构：

[1] Univ Med Ctr Rotterdam, Erasmus MC, Dept Rheumatol, POB 2040, NL-3000 CA Rotterdam, Netherlands

[2] Vlietland Hosp, Dept Rheumatol, Schiedam, Netherlands

[3] Maasstad Hosp, Dept Rheumatol, Rotterdam, Netherlands

[4] St Franciscus Gasthuis, Dept Rheumatol, Rotterdam, Netherlands

[5] Albert Schweitzer Hosp, Dept Rheumatol, Dordrecht, Netherlands

[6] Admiraal de Ruyter Hosp, Dept Rheumatol, Goes, Netherlands

[7] Zorgsaam Hosp, Dept Rheumatol, Terneuzen, Netherlands

来源：

RHEUMATOLOGY | 2016年 / 55卷 / 04期

关键词：

classification criteria; rheumatoid arthritis; diagnostic criteria; RHEUMATOLOGY/EUROPEAN LEAGUE; AMERICAN-COLLEGE; UNDIFFERENTIATED ARTHRITIS; METHODOLOGICAL REPORT; PERFORMANCE; DISEASE;

D O I：

10.1093/rheumatology/kev383

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective. In this study we aimed to evaluate the effect of lowering the cut point of the 2010 criteria to identify more patients with RA among early inflammatory arthritis patients. Methods. We included early arthritis patients from the Rotterdam Early Arthritis Cohort with at least one joint with clinical synovitis and symptoms for <1 year, with no other explanation for their symptoms. The demographic and clinical characteristics of each patient were recorded at baseline. Patients were classified as case or non-case at the 1-year follow-up by the definition used in the development of the 2010 criteria (MTX initiation). To assess the diagnostic performance of the 2010 criteria, the sensitivity and specificity at each cut point were determined. Results. We included 557 patients in our analysis. At the 1-year follow-up, 253 patients (45%) were classified as case (MTX use). In the group of patients who scored 0-5 points (n=320. 98 patients (30%) were classified as case (MTX use). The sensitivity and specificity of the 2010 criteria using the cut point of 6 were 61% and 76%, respectively. With the cut point of 5, the sensitivity would increase to 76% and the specificity would decrease to 68%. Conclusion. By lowering the cut point of the 2010 criteria from 6 to 5 points, we were able to identify 15% more RA patients at the cost of 8% more false-positive patients.

引用

页码：636 / 639

页数：4

共 14 条

[1] 2010 Rheumatoid Arthritis Classification Criteria An American College of Rheumatology/European League Against Rheumatism Collaborative Initiative [J].

Aletaha, Daniel ;

Neogi, Tuhina ;

Silman, Alan J. ;

Funovits, Julia ;

Felson, David T. ;

Bingham, Clifton O., III ;

Birnbaum, Neal S. ;

Burmester, Gerd R. ;

Bykerk, Vivian P. ;

Cohen, Marc D. ;

Combe, Bernard ;

Costenbader, Karen H. ;

Dougados, Maxime ;

Emery, Paul ;

Ferraccioli, Gianfranco ;

Hazes, Johanna M. W. ;

Hobbs, Kathryn ;

Huizinga, Tom W. J. ;

Kavanaugh, Arthur ;

Kay, Jonathan ;

Kvien, Tore K. ;

Laing, Timothy ;

Mease, Philip ;

Menard, Henri A. ;

Moreland, Larry W. ;

Naden, Raymond L. ;

Pincus, Theodore ;

Smolen, Josef S. ;

Stanislawska-Biernat, Ewa ;

Symmons, Deborah ;

Tak, Paul P. ;

Upchurch, Katherine S. ;

Vencovsky, Jiri ;

Wolfe, Frederick ;

Hawker, Gillian .

ARTHRITIS AND RHEUMATISM, 2010, 62 (09) :2569-2581

[2] Diagnostic performance of the ACR/EULAR 2010 criteria for rheumatoid arthritis and two diagnostic algorithms in an early arthritis clinic (REACH) [J].

Alves, Celina ;

Luime, Jolanda Jacoba ;

van Zeben, Derkjen ;

Huisman, Anne-Margriet ;

Weel, Angelique Elisabeth Adriana Maria ;

Barendregt, Pieternella Johanna ;

Hazes, Johanna Maria Wilhelmina .

ANNALS OF THE RHEUMATIC DISEASES, 2011, 70 (09) :1645-1647

[3] Performance of a multi-biomarker score measuring rheumatoid arthritis disease activity in the CAMERA tight control study [J].

Bakker, Marije F. ;

Cavet, Guy ;

Jacobs, Johannes W. G. ;

Bijlsma, Johannes W. J. ;

Haney, Douglas J. ;

Shen, Yijing ;

Hesterberg, Lyndal K. ;

Smith, Dustin R. ;

Centola, Michael ;

van Roon, Joel A. G. ;

Lafeber, Floris P. J. G. ;

Welsing, Paco M. J. .

ANNALS OF THE RHEUMATIC DISEASES, 2012, 71 (10) :1692-1697

[4] Utility of ultrasound joint counts in the prediction of rheumatoid arthritis in patients with very early synovitis [J].

Filer, Andrew ;

de Pablo, Paola ;

Allen, Gina ;

Nightingale, Peter ;

Jordan, Alison ;

Jobanputra, Paresh ;

Bowman, Simon ;

Buckley, Christopher D. ;

Raza, Karim .

ANNALS OF THE RHEUMATIC DISEASES, 2011, 70 (03) :500-507

[5] The 2010 American College of Rheumatology/European League Against Rheumatism classification criteria for rheumatoid arthritis: Methodological Report Phase I [J].

Funovits, Julia ;

Aletaha, Daniel ;

Bykerk, Vivian ;

Combe, Bernard ;

Dougados, Maxime ;

Emery, Paul ;

Felson, David ;

Hawker, Gillian ;

Hazes, Joanna M. ;

Huizinga, Tom ;

Kay, Jonathan ;

Kvien, Tore K. ;

Smolen, Josef S. ;

Symmons, Deborah ;

Tak, Paul P. ;

Silman, Alan .

ANNALS OF THE RHEUMATIC DISEASES, 2010, 69 (09) :1589-1595

[6]

Geuskens GA, 2008, J RHEUMATOL, V35, P1754

[7] Undifferentiated arthritis characteristics and outcomes when applying the 2010 and 1987 criteria for rheumatoid arthritis [J].

Krabben, A. ;

Huizinga, T. W. J. ;

van der Helm-van Mil, A. H. M. .

ANNALS OF THE RHEUMATIC DISEASES, 2012, 71 (02) :238-241

[8] Risk of rheumatoid arthritis development in patients with unclassified arthritis according to the 2010 ACR/EULAR criteria for rheumatoid arthritis [J].

Krabben, Annemarie ;

Abhishek, Abhishek ;

Britsemmer, Karin ;

Filer, Andrew ;

Huizinga, Tom W. J. ;

Raza, Karim ;

van Schaardenburg, Dirk-Jan ;

van der Helm-van Mil, Annette H. M. .

RHEUMATOLOGY, 2013, 52 (07) :1265-1270

[9] The 2010 American College of Rheumatology/European League Against Rheumatism Classification Criteria for Rheumatoid Arthritis Phase 2 Methodological Report [J].

Neogi, Tuhina ;

Aletaha, Daniel ;

Silman, Alan J. ;

Naden, Raymond L. ;

Felson, David T. ;

Aggarwal, Rohit ;

Bingham, Clifton O., III ;

Birnbaum, Neal S. ;

Burmester, Gerd R. ;

Bykerk, Vivian P. ;

Cohen, Marc D. ;

Combe, Bernard ;

Costenbader, Karen H. ;

Dougados, Maxime ;

Emery, Paul ;

Ferraccioli, Gianfranco ;

Hazes, Johanna M. W. ;

Hobbs, Kathryn ;

Huizinga, Tom W. J. ;

Kavanaugh, Arthur ;

Kay, Jonathan ;

Khanna, Dinesh ;

Kvien, Tore K. ;

Laing, Timothy ;

Liao, Katherine ;

Mease, Philip ;

Menard, Henri A. ;

Moreland, Larry W. ;

Nair, Raj ;

Pincus, Theodore ;

Ringold, Sarah ;

Smolen, Josef S. ;

Stanislawska-Biernat, Ewa ;

Symmons, Deborah ;

Tak, Paul P. ;

Upchurch, Katherine S. ;

Vencovsky, Jiri ;

Wolfe, Frederick ;

Hawker, Gillian .

ARTHRITIS AND RHEUMATISM, 2010, 62 (09) :2582-2591

[10] Performance of the 2010 ACR/EULAR classification criteria for rheumatoid arthritis: a systematic literature review [J].

Radner, Helga ;

Neogi, Tuhina ;

Smolen, Josef S. ;

Aletaha, Daniel .

ANNALS OF THE RHEUMATIC DISEASES, 2014, 73 (01) :114-123

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