Comparison of ACR 1987 and ACR/EULAR 2010 criteria for predicting a 10-year diagnosis of rheumatoid arthritis.

Abstract : OBJECTIVE: To compare the diagnostic accuracy of the 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) and 1987 ACR criteria for rheumatoid arthritis (RA) in a cohort of patients with recent-onset arthritis followed-up for 10 years. METHODS: One hundred and sixty-four patients with recent-onset arthritis of less than 1 year's duration were included prospectively between 1995 and 1997. The diagnosis of RA was defined as having a diagnosis of RA made by the office-based rheumatologist 10 years after enrolment. We compared the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the criteria sets at baseline. RESULTS: At baseline, 60 of the 164 patients had alternative diagnoses better explaining the arthritis and 13 had erosions typical for RA; of the 91 remaining patients, 33 had at least 6 ACR/EULAR points (indicating definite RA), and 58 had fewer than 6 points. The ACR/EULAR criteria had a quite similar sensitivity than the 1987 ACR criteria (33/57 [57.9%] for ACR/EULAR criteria vs 34/57 [59.6%] for the 1987 ACR criteria), but higher specificity, PPV, and NPV (95/107 [88.8%], 34/46 [73.9%], and 95/118 [80.5%], respectively) than the 1987 ACR criteria (80/107 [74.8%], 33/63 [52.4%], and 80/104 [76.9%], respectively). CONCLUSION: ACR/EULAR criteria performed substantially better than ACR 1987 criteria for predicting a diagnosis of RA after 10 years. Much of the improvement was ascribable to the use of exclusion criteria. BULLET POINTS: (1) The ACR/EULAR criteria had the same sensitivity, but higher specificity, PPV, and NPV than the 1987 ACR criteria; (2) Much of the improvement was ascribable to the use of exclusion criteria.
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Joint Bone Spine, Elsevier Masson, 2012, 79 (6), pp.581-5. 〈10.1016/j.jbspin.2012.01.015〉
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http://hal.univ-brest.fr/hal-00777333
Contributeur : Geneviève Michel <>
Soumis le : jeudi 17 janvier 2013 - 13:18:20
Dernière modification le : lundi 4 décembre 2017 - 10:36:43

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Divi Cornec, Sophie Varache, Johanne Morvan, Valérie Devauchelle-Pensec, Jean-Marie Berthelot, et al.. Comparison of ACR 1987 and ACR/EULAR 2010 criteria for predicting a 10-year diagnosis of rheumatoid arthritis.. Joint Bone Spine, Elsevier Masson, 2012, 79 (6), pp.581-5. 〈10.1016/j.jbspin.2012.01.015〉. 〈hal-00777333〉

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