Dataset Information

Utility of the new rheumatoid arthritis 2010 ACR/EULAR classification criteria in routine clinical care.

ABSTRACT:

Objectives

The new 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria for rheumatoid arthritis (RA) have been designed to classify early onset RA, but has not been studied to identify RA in patients with arthritis seen in routine clinical care where correct 'classification' of patients, when they are not selected for having RA would be important.

Design

Prospective, consecutive patients cohort.

Setting

Outpatient clinic of a university rheumatology centre.

Participants

A total of 126 patients with joint symptoms were consecutively recruited.

Interventions

The ACR/EULAR RA criteria were applied, with questions followed by a targeted musculoskeletal exam. The gold standard for the diagnosis of RA was the primary rheumatologist's diagnosis.

Primary outcome measure

Number of patients with non-RA diagnosis who were classified as having RA by the new classification criteria.

Results

The sensitivity and specificity of the 2010 criteria in classifying RA were 97% and 55%, respectively, compared with the 1987 RA criteria which were 93% and 76%, respectively. The 2010 criteria as applied to this group of patients had a poorer positive predictive (44% vs 61%) and a similar negative predictive value (98% vs 97%) compared with the 1987 criteria. More specifically, 66.7% of systemic lupus erythematosus patients, 50% of osteoarthritis, 37.5% of psoriatic arthritis and 27.2% of others fulfilled the new criteria and could have been classified as RA.

Conclusions

In this, we believe, the first study to examine the new 2010 ACR/EULAR RA criteria among consecutive patients seen in routine care, we found the criteria to have low specificity, and therefore incorrectly label those as having RA when, in fact, they may have a different type of inflammatory arthritis. Physicians need to be aware of this when applying the new criteria for classifying their patients for any purpose.

SUBMITTER: Kennish L

PROVIDER: S-EPMC3488748 | biostudies-literature | 2012

REPOSITORIES: biostudies-literature

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Publications

Utility of the new rheumatoid arthritis 2010 ACR/EULAR classification criteria in routine clinical care.

Kennish Lauren L Labitigan Monalyn M Budoff Sam S Filopoulos Maria T MT McCracken W Andrew WA Swearingen Christopher J CJ Yazici Yusuf Y

BMJ open 20121003 5

<h4>Objectives</h4>The new 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria for rheumatoid arthritis (RA) have been designed to classify early onset RA, but has not been studied to identify RA in patients with arthritis seen in routine clinical care where correct 'classification' of patients, when they are not selected for having RA would be important.<h4>Design</h4>Prospective, consecutive patients cohort.<h4>Setting</h4>Outpatient clinic of a univer ...[more]

PMID: 23035013

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Project description:BackgroundThe aim of this study was to validate the 2019 European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) classification criteria for systemic lupus erythematosus (SLE) in antinuclear antibody (ANA)-positive Chinese patients.MethodsMedical records of all adult patients who attended the rheumatology out-patient clinics between May and September 2019 were reviewed. Patients with ever ANA positive (titre ⩾1:80) were included and evaluated for the fulfilment of the 2019 EULAR/ACR, 2012 Systemic Lupus International Collaborating Clinics (SLICC) and 1997 ACR criteria for SLE classification. The performance of these criteria in predicting a clinical diagnosis of SLE as judged by an independent panel of rheumatologists was studied and compared in different subgroups.ResultsA total of 1533 patients (88.2% women; age at first clinic attendance 45.5 ± 15.6 years) were studied and 562 patients were judged to be clinical SLE. The sensitivity and specificity of the EULAR/ACR (⩾10 points), SLICC and ACR criteria for a clinical diagnosis of SLE was 96.1%, 97.9% and 86.1%; and 85.8%, 86.3% and 94.3%, respectively. Applying the attribution rule to the non-SLE controls, the specificity of the three criteria increased to 95.0%, 92.5% and 98.8%, respectively. The specificity of the EULAR/ACR criteria was higher in male patients (97.9%), those aged >50 years (97.0%) and disease duration of ⩽3 years (97.6%). Using a cut-off of 12 points, the specificity of the EULAR/ACR criteria was further increased (96.6%) while a high sensitivity (95.0%) was maintained.ConclusionIn Chinese patients with a positive ANA, the EULAR/ACR criteria for clinical SLE perform equally well to the SLICC criteria. Both the EULAR/ACR and SLICC are more sensitive but less specific than the ACR criteria. The specificity of all the three criteria is enhanced by applying the attribution rule to controls. The specificity of the EULAR/ACR criteria is higher in certain patient subgroups or when the cut-off score is raised.

Dataset Information

Utility of the new rheumatoid arthritis 2010 ACR/EULAR classification criteria in routine clinical care.

Objectives

Design

Setting

Participants

Interventions

Primary outcome measure

Results

Conclusions

Publications

Utility of the new rheumatoid arthritis 2010 ACR/EULAR classification criteria in routine clinical care.

Similar Datasets

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