Rheumatology

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Changes over time in the diagnosis of rheumatoid arthritis in a 10-year cohort
Journal of Rheumatology, 10/19/09

Morvan J et al. – ACR criteria for RA showed poor performance even at 2 years. The absence of exclusion criteria may explain the lack of specificity, which improved when combined with the OBR diagnosis. Adding anti-CCP criteria to the existing criteria could help in diagnosing RA.

• 270 patients with recent-onset arthritis of < 1 y duration were included between 1995 and 1997 and followed for 2 years
• Diagnosis recorded by office-based rheumatologist (OBR) at inclusion, and 2 years later
• In 2007, questionnaire sent to each rheumatologist to collect the final diagnosis
• Final diagnosis considered reference

• Final diagnosis available for 164 patients: 57 had RA
• Agreement was low between baseline and final diagnoses, and substantial between the 2-y and final diagnoses
• Anti-CCP-revised criteria had sensitivity of 65% to 81% and specificity of 55% to 75%
• Combination OBR diagnosis/ACR criteria after 2 y showed considerably increased specificity (87% vs 64%) and slightly decreased sensitivity (77% vs 81%)

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