Clinical Assessment of the 1987 American College of Rheumatology Criteria for Rheumatoid Arthritis
The 1987 American College of Rheumatology (ACR) criteria for the classification of rheumatoid arthritis (RA) were clinically assessed. These criteria do not include findings of synovial fluid (SF) analysis and require no exclusion criteria. We have studied sequential patients with arthritis seen in...
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| Veröffentlicht in: | Scandinavian journal of rheumatology 1996, Vol.25 (5), p.277-281 |
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| container_title | Scandinavian journal of rheumatology |
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| creator | Levin, R. W. Park, J. Ostrov, B. Reginato, A. Baker, D. G. Bomalaski, J. S. Borofsky, M. Gardiner, M. Leventhal, L. Louthrenoo, W. von Feldt, J. Kolasinski, S. Schumacher, H. R. |
| description | The 1987 American College of Rheumatology (ACR) criteria for the classification of rheumatoid arthritis (RA) were clinically assessed. These criteria do not include findings of synovial fluid (SF) analysis and require no exclusion criteria. We have studied sequential patients with arthritis seen in four rheumatology centers in the Philadelphia area. Classifications by the ACR criteria were compared with our clinical diagnoses. Two hundred ninety eight patients were evaluated, 113 with RA and 185 with other diagnoses. Classifications as RA by the ACR criteria corresponded to our clinical diagnosis in 95% of the cases, corroborating the high sensitivity previously reported. However, we found a lower specificity (73%) than that reported (89%). False positive classifications as RA were found in 71% of patients with psoriatic arthritis, 48% of patients with SLE, and 31% of patients with gout. The specificity could be improved to 89% by excluding disorders with obvious distinguishing extraarticular features such as psoriasis or by SF findings of monosodium urate crystals. Awareness of these possible sources of confusion will further increase the teaching and epidemiologic value of these useful simplified criteria. |
| doi_str_mv | 10.3109/03009749609104058 |
| format | Article |
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W. ; Park, J. ; Ostrov, B. ; Reginato, A. ; Baker, D. G. ; Bomalaski, J. S. ; Borofsky, M. ; Gardiner, M. ; Leventhal, L. ; Louthrenoo, W. ; von Feldt, J. ; Kolasinski, S. ; Schumacher, H. R.</creator><creatorcontrib>Levin, R. W. ; Park, J. ; Ostrov, B. ; Reginato, A. ; Baker, D. G. ; Bomalaski, J. S. ; Borofsky, M. ; Gardiner, M. ; Leventhal, L. ; Louthrenoo, W. ; von Feldt, J. ; Kolasinski, S. ; Schumacher, H. R.</creatorcontrib><description>The 1987 American College of Rheumatology (ACR) criteria for the classification of rheumatoid arthritis (RA) were clinically assessed. These criteria do not include findings of synovial fluid (SF) analysis and require no exclusion criteria. We have studied sequential patients with arthritis seen in four rheumatology centers in the Philadelphia area. Classifications by the ACR criteria were compared with our clinical diagnoses. Two hundred ninety eight patients were evaluated, 113 with RA and 185 with other diagnoses. Classifications as RA by the ACR criteria corresponded to our clinical diagnosis in 95% of the cases, corroborating the high sensitivity previously reported. However, we found a lower specificity (73%) than that reported (89%). False positive classifications as RA were found in 71% of patients with psoriatic arthritis, 48% of patients with SLE, and 31% of patients with gout. The specificity could be improved to 89% by excluding disorders with obvious distinguishing extraarticular features such as psoriasis or by SF findings of monosodium urate crystals. Awareness of these possible sources of confusion will further increase the teaching and epidemiologic value of these useful simplified criteria.</description><identifier>ISSN: 0300-9742</identifier><identifier>EISSN: 1502-7732</identifier><identifier>DOI: 10.3109/03009749609104058</identifier><identifier>PMID: 8921919</identifier><identifier>CODEN: SJRHAT</identifier><language>eng</language><publisher>Colchester: Informa UK Ltd</publisher><subject>Adult ; Aged ; Arthritis, Rheumatoid - diagnosis ; Biological and medical sciences ; criteria ; Diagnosis, Differential ; Diseases of the osteoarticular system ; False Positive Reactions ; Female ; Humans ; Inflammatory joint diseases ; Male ; Medical sciences ; Middle Aged ; Practice Guidelines as Topic - standards ; Prospective Studies ; rheumatoid arthritis ; Rheumatology - standards ; Sensitivity and Specificity ; Societies, Medical - standards ; synovial fluid</subject><ispartof>Scandinavian journal of rheumatology, 1996, Vol.25 (5), p.277-281</ispartof><rights>1996 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted 1996</rights><rights>1997 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c498t-85a5a978f1596ff1da4275bd0bc5e9206a2617e52a5e8a6758f0db3ceab12b9d3</citedby><cites>FETCH-LOGICAL-c498t-85a5a978f1596ff1da4275bd0bc5e9206a2617e52a5e8a6758f0db3ceab12b9d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.tandfonline.com/doi/pdf/10.3109/03009749609104058$$EPDF$$P50$$Ginformahealthcare$$H</linktopdf><linktohtml>$$Uhttps://www.tandfonline.com/doi/full/10.3109/03009749609104058$$EHTML$$P50$$Ginformahealthcare$$H</linktohtml><link.rule.ids>314,780,784,4024,27923,27924,27925,59647,59753,60436,60542,61221,61256,61402,61437</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2471334$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8921919$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Levin, R. W.</creatorcontrib><creatorcontrib>Park, J.</creatorcontrib><creatorcontrib>Ostrov, B.</creatorcontrib><creatorcontrib>Reginato, A.</creatorcontrib><creatorcontrib>Baker, D. G.</creatorcontrib><creatorcontrib>Bomalaski, J. S.</creatorcontrib><creatorcontrib>Borofsky, M.</creatorcontrib><creatorcontrib>Gardiner, M.</creatorcontrib><creatorcontrib>Leventhal, L.</creatorcontrib><creatorcontrib>Louthrenoo, W.</creatorcontrib><creatorcontrib>von Feldt, J.</creatorcontrib><creatorcontrib>Kolasinski, S.</creatorcontrib><creatorcontrib>Schumacher, H. R.</creatorcontrib><title>Clinical Assessment of the 1987 American College of Rheumatology Criteria for Rheumatoid Arthritis</title><title>Scandinavian journal of rheumatology</title><addtitle>Scand J Rheumatol</addtitle><description>The 1987 American College of Rheumatology (ACR) criteria for the classification of rheumatoid arthritis (RA) were clinically assessed. These criteria do not include findings of synovial fluid (SF) analysis and require no exclusion criteria. We have studied sequential patients with arthritis seen in four rheumatology centers in the Philadelphia area. Classifications by the ACR criteria were compared with our clinical diagnoses. Two hundred ninety eight patients were evaluated, 113 with RA and 185 with other diagnoses. Classifications as RA by the ACR criteria corresponded to our clinical diagnosis in 95% of the cases, corroborating the high sensitivity previously reported. However, we found a lower specificity (73%) than that reported (89%). False positive classifications as RA were found in 71% of patients with psoriatic arthritis, 48% of patients with SLE, and 31% of patients with gout. The specificity could be improved to 89% by excluding disorders with obvious distinguishing extraarticular features such as psoriasis or by SF findings of monosodium urate crystals. Awareness of these possible sources of confusion will further increase the teaching and epidemiologic value of these useful simplified criteria.</description><subject>Adult</subject><subject>Aged</subject><subject>Arthritis, Rheumatoid - diagnosis</subject><subject>Biological and medical sciences</subject><subject>criteria</subject><subject>Diagnosis, Differential</subject><subject>Diseases of the osteoarticular system</subject><subject>False Positive Reactions</subject><subject>Female</subject><subject>Humans</subject><subject>Inflammatory joint diseases</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Practice Guidelines as Topic - standards</subject><subject>Prospective Studies</subject><subject>rheumatoid arthritis</subject><subject>Rheumatology - standards</subject><subject>Sensitivity and Specificity</subject><subject>Societies, Medical - standards</subject><subject>synovial fluid</subject><issn>0300-9742</issn><issn>1502-7732</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1996</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEGL1DAYhoMo6zi7P8CD0IPsrZqkTZOgl6Gsu8KCIHouX9sv2yxpsyYpMv_eDDMOiLCnHJ7nDclDyFtGP1SM6o-0olTLWjdUM1pToV6QDROUl1JW_CXZHHiZBf6avInxkVJaa6kvyIXSnGmmN6RvnV3sAK7YxYgxzrikwpsiTVgwrWSxmzFkvhStdw4f8AC_T7jOkLzzD_uiDTZlBQrjw5nYsdiFNGVk4yV5ZcBFvDqdW_Lzy82P9q68_3b7td3dl0OtVSqVAAFaKsOEboxhI9Rcin6k_SBQc9oAb5hEwUGggkYKZejYVwNCz3ivx2pLro_3PgX_a8WYutnGAZ2DBf0aO6lEzZtcZkvYURyCjzGg6Z6CnSHsO0a7Q9fuv6558-50-drPOJ4Xp5CZvz9xiLmmCbAMNp41XktWVXXWPh81u-RcM_z2wY1dgr3z4e-meu4Vn_6ZTwguTQME7B79Gpac95k__AEACaTa</recordid><startdate>1996</startdate><enddate>1996</enddate><creator>Levin, R. W.</creator><creator>Park, J.</creator><creator>Ostrov, B.</creator><creator>Reginato, A.</creator><creator>Baker, D. G.</creator><creator>Bomalaski, J. S.</creator><creator>Borofsky, M.</creator><creator>Gardiner, M.</creator><creator>Leventhal, L.</creator><creator>Louthrenoo, W.</creator><creator>von Feldt, J.</creator><creator>Kolasinski, S.</creator><creator>Schumacher, H. R.</creator><general>Informa UK Ltd</general><general>Taylor & Francis</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>1996</creationdate><title>Clinical Assessment of the 1987 American College of Rheumatology Criteria for Rheumatoid Arthritis</title><author>Levin, R. W. ; Park, J. ; Ostrov, B. ; Reginato, A. ; Baker, D. G. ; Bomalaski, J. S. ; Borofsky, M. ; Gardiner, M. ; Leventhal, L. ; Louthrenoo, W. ; von Feldt, J. ; Kolasinski, S. ; Schumacher, H. 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W.</creatorcontrib><creatorcontrib>Park, J.</creatorcontrib><creatorcontrib>Ostrov, B.</creatorcontrib><creatorcontrib>Reginato, A.</creatorcontrib><creatorcontrib>Baker, D. G.</creatorcontrib><creatorcontrib>Bomalaski, J. S.</creatorcontrib><creatorcontrib>Borofsky, M.</creatorcontrib><creatorcontrib>Gardiner, M.</creatorcontrib><creatorcontrib>Leventhal, L.</creatorcontrib><creatorcontrib>Louthrenoo, W.</creatorcontrib><creatorcontrib>von Feldt, J.</creatorcontrib><creatorcontrib>Kolasinski, S.</creatorcontrib><creatorcontrib>Schumacher, H. 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R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical Assessment of the 1987 American College of Rheumatology Criteria for Rheumatoid Arthritis</atitle><jtitle>Scandinavian journal of rheumatology</jtitle><addtitle>Scand J Rheumatol</addtitle><date>1996</date><risdate>1996</risdate><volume>25</volume><issue>5</issue><spage>277</spage><epage>281</epage><pages>277-281</pages><issn>0300-9742</issn><eissn>1502-7732</eissn><coden>SJRHAT</coden><abstract>The 1987 American College of Rheumatology (ACR) criteria for the classification of rheumatoid arthritis (RA) were clinically assessed. These criteria do not include findings of synovial fluid (SF) analysis and require no exclusion criteria. We have studied sequential patients with arthritis seen in four rheumatology centers in the Philadelphia area. Classifications by the ACR criteria were compared with our clinical diagnoses. Two hundred ninety eight patients were evaluated, 113 with RA and 185 with other diagnoses. Classifications as RA by the ACR criteria corresponded to our clinical diagnosis in 95% of the cases, corroborating the high sensitivity previously reported. However, we found a lower specificity (73%) than that reported (89%). False positive classifications as RA were found in 71% of patients with psoriatic arthritis, 48% of patients with SLE, and 31% of patients with gout. The specificity could be improved to 89% by excluding disorders with obvious distinguishing extraarticular features such as psoriasis or by SF findings of monosodium urate crystals. Awareness of these possible sources of confusion will further increase the teaching and epidemiologic value of these useful simplified criteria.</abstract><cop>Colchester</cop><pub>Informa UK Ltd</pub><pmid>8921919</pmid><doi>10.3109/03009749609104058</doi><tpages>5</tpages></addata></record> |
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| identifier | ISSN: 0300-9742 |
| ispartof | Scandinavian journal of rheumatology, 1996, Vol.25 (5), p.277-281 |
| issn | 0300-9742 1502-7732 |
| language | eng |
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| source | MEDLINE; Taylor & Francis Medical Library - CRKN; Taylor & Francis Journals Complete |
| subjects | Adult Aged Arthritis, Rheumatoid - diagnosis Biological and medical sciences criteria Diagnosis, Differential Diseases of the osteoarticular system False Positive Reactions Female Humans Inflammatory joint diseases Male Medical sciences Middle Aged Practice Guidelines as Topic - standards Prospective Studies rheumatoid arthritis Rheumatology - standards Sensitivity and Specificity Societies, Medical - standards synovial fluid |
| title | Clinical Assessment of the 1987 American College of Rheumatology Criteria for Rheumatoid Arthritis |
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