| Relative clinical influence of clinical, laboratory, and radiological investigations in early arthritis on the diagnosis of rheumatoid arthritis. Data from the French Early Arthritis Cohort ESPOIR. | |
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MedLine Citation:
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PMID: 20952470 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate the relative level of influence of usual investigations in early arthritis on the diagnosis of rheumatoid arthritis (RA). METHODS: Patients: those included in the ESPOIR early arthritis cohort, a national cohort of patients with grade ≥ 2 synovitis for > 6 weeks and < 6 months. The diagnostic properties of variables assessed at baseline were measured against the diagnosis of RA defined by American College of Rheumatology criteria (at any timepoint between inclusion and 12-month followup) and expert opinion. Various models, including (1) clinical data; (2) clinical + radiographic data (plain radiographs); (3) addition of rheumatoid factor (RF) and/or anti-cyclic citrullinated peptide (anti-CCP); and (4) addition of HLA-DR typing, were assessed by comparing areas under the curves for ROC curves. RESULTS: Of 731 patients studied, 372 (50.9%) satisfied criteria for RA at 1 year. In univariate analysis, sensitivity was highest for distal articular presentation (94.6%), presence of IgM RF (69.4%), pain on metatarso-phalangeal squeeze test (66.1%), and presence of anti-CCP (65.6%); whereas specificity was highest for nodules (100%), HLA typing: shared-epitope double dose (95.9%), radiographic erosions (86.5%), and anti-CCP antibodies (86.4%). The most efficient model included swollen joint count, morning stiffness, erosions, RF, and anti-CCP. Adding rheumatoid nodules, C-reactive protein, or HLA-DR information was not contributive. CONCLUSION: In addition to the clinical variables and radiographs, RF and/or anti-CCP are the single variables of interest that are contributive for the diagnosis of RA. |
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Authors:
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Laure Gossec; Christophe Combescure; Nathalie Rincheval; Alain Saraux; Bernard Combe; Maxime Dougados |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-10-15 |
Journal Detail:
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Title: The Journal of rheumatology Volume: 37 ISSN: 0315-162X ISO Abbreviation: J. Rheumatol. Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-12-02 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7501984 Medline TA: J Rheumatol Country: Canada |
Other Details:
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Languages: eng Pagination: 2486-92 Citation Subset: IM |
Affiliation:
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Faculty of Medicine, Paris Descartes University, UPRES-EA 4058, APHP, Department of Rheumatology B, Cochin Hospital, Paris, France. laure.gossec@cch.aphp.fr |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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