Performance of the 2010 classification criteria for rheumatoid arthritis: a systematic literature review and a meta-analysis.

<h4>Objectives</h4>To evaluate the performance of the American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) 2010 classification criteria for rheumatoid arthritis (RA) with a systematic literature review and a meta-analysis.<h4>Methods</h4>PubMed, E...

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Autores principales:	Garifallia Sakellariou, Carlo Alberto Scirè, Antonella Zambon, Roberto Caporali, Carlomaurizio Montecucco
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/42ef02bb3c6848b487d7b20a664391f0
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spelling	oai:doaj.org-article:42ef02bb3c6848b487d7b20a664391f02021-11-18T07:56:53ZPerformance of the 2010 classification criteria for rheumatoid arthritis: a systematic literature review and a meta-analysis.1932-620310.1371/journal.pone.0056528https://doaj.org/article/42ef02bb3c6848b487d7b20a664391f02013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23437156/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objectives</h4>To evaluate the performance of the American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) 2010 classification criteria for rheumatoid arthritis (RA) with a systematic literature review and a meta-analysis.<h4>Methods</h4>PubMed, Embase, Cochrane Library and the abstracts of the ACR and EULAR meetings (2010-2012) were searched for original articles or abstracts with the following inclusion criteria: 1) recent onset arthritis, with at least one swollen joint and no alternative diagnosis; 2) the ACR/EULAR 2010 criteria as index test; 3) the prescription of methotrexate (MTX) or disease modifying antirheumatic drugs (DMARDs) at any time during follow-up as reference standard. Data were pooled using the bivariate model. Three meta-analyses were performed with MTX (primary analysis), DMARDs or their combination (secondary analyses) as reference standard. Heterogeneity was formally tested and explored performing an influence analysis.<h4>Results</h4>The search identified 1,277 references. Six full papers and 4 abstracts met the inclusion criteria. With MTX as reference standard, sensitivity (95% confidence interval, CI) was 0.80 (0.74,0.85), specificity 0.61 (0.56,0.67), positive likelihood ratio (LR) 2.11 (1.92,2.32), negative LR 0.31 (0.25,0.38) and the diagnostic odds ratio (DOR) was 6.74 (5.49,8.28). Using DMARDs as reference standard, sensitivity was 0.73 (0.64,0.80), specificity was 0.74 (0.68,0.79), LR+2.85 (2.53,3.22), LR- 0.35 (0.27,0.45) and DOR 8.03 (6.4,10.09). Using the combination of MTX and DMARDs as reference standard, intermediate results were obtained. The influence analysis detected one potentially influential study. However, its exclusion from the meta-analysis did not have a clinically relevant impact on the results.<h4>Conclusions</h4>The new classification criteria have good sensitivity, lower specificity and an overall moderate diagnostic accuracy. These results confirm that the criteria have classificative and not diagnostic function.Garifallia SakellariouCarlo Alberto ScirèAntonella ZambonRoberto CaporaliCarlomaurizio MontecuccoPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 2, p e56528 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Garifallia Sakellariou Carlo Alberto Scirè Antonella Zambon Roberto Caporali Carlomaurizio Montecucco Performance of the 2010 classification criteria for rheumatoid arthritis: a systematic literature review and a meta-analysis.
description	<h4>Objectives</h4>To evaluate the performance of the American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) 2010 classification criteria for rheumatoid arthritis (RA) with a systematic literature review and a meta-analysis.<h4>Methods</h4>PubMed, Embase, Cochrane Library and the abstracts of the ACR and EULAR meetings (2010-2012) were searched for original articles or abstracts with the following inclusion criteria: 1) recent onset arthritis, with at least one swollen joint and no alternative diagnosis; 2) the ACR/EULAR 2010 criteria as index test; 3) the prescription of methotrexate (MTX) or disease modifying antirheumatic drugs (DMARDs) at any time during follow-up as reference standard. Data were pooled using the bivariate model. Three meta-analyses were performed with MTX (primary analysis), DMARDs or their combination (secondary analyses) as reference standard. Heterogeneity was formally tested and explored performing an influence analysis.<h4>Results</h4>The search identified 1,277 references. Six full papers and 4 abstracts met the inclusion criteria. With MTX as reference standard, sensitivity (95% confidence interval, CI) was 0.80 (0.74,0.85), specificity 0.61 (0.56,0.67), positive likelihood ratio (LR) 2.11 (1.92,2.32), negative LR 0.31 (0.25,0.38) and the diagnostic odds ratio (DOR) was 6.74 (5.49,8.28). Using DMARDs as reference standard, sensitivity was 0.73 (0.64,0.80), specificity was 0.74 (0.68,0.79), LR+2.85 (2.53,3.22), LR- 0.35 (0.27,0.45) and DOR 8.03 (6.4,10.09). Using the combination of MTX and DMARDs as reference standard, intermediate results were obtained. The influence analysis detected one potentially influential study. However, its exclusion from the meta-analysis did not have a clinically relevant impact on the results.<h4>Conclusions</h4>The new classification criteria have good sensitivity, lower specificity and an overall moderate diagnostic accuracy. These results confirm that the criteria have classificative and not diagnostic function.
format	article
author	Garifallia Sakellariou Carlo Alberto Scirè Antonella Zambon Roberto Caporali Carlomaurizio Montecucco
author_facet	Garifallia Sakellariou Carlo Alberto Scirè Antonella Zambon Roberto Caporali Carlomaurizio Montecucco
author_sort	Garifallia Sakellariou
title	Performance of the 2010 classification criteria for rheumatoid arthritis: a systematic literature review and a meta-analysis.
title_short	Performance of the 2010 classification criteria for rheumatoid arthritis: a systematic literature review and a meta-analysis.
title_full	Performance of the 2010 classification criteria for rheumatoid arthritis: a systematic literature review and a meta-analysis.
title_fullStr	Performance of the 2010 classification criteria for rheumatoid arthritis: a systematic literature review and a meta-analysis.
title_full_unstemmed	Performance of the 2010 classification criteria for rheumatoid arthritis: a systematic literature review and a meta-analysis.
title_sort	performance of the 2010 classification criteria for rheumatoid arthritis: a systematic literature review and a meta-analysis.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/42ef02bb3c6848b487d7b20a664391f0
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Performance of the 2010 classification criteria for rheumatoid arthritis: a systematic literature review and a meta-analysis.

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