Clinical validation of the 2012 classification criteria for early rheumatoid arthritisin: a domestic multi-center cohort

Abstract

Objective To evaluate the value of 2012 classification criteria for early rheumatoid arthritis (ERA), 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria, and 1987 ACR classification criteria in the diagnosis of early rheumatoid arthritis (RA). Methods Patients who had at least one swollen and tender joint with disease duration no more than 2 years, and age more than 16 years were enrolled. The patients were diagnosed as RA or other non-RA by 2 exper-ienced rheumatologists. The clinical and laboratory parameters were recorded. The sensitivity and specificity of three RA classification criteria were compared by McNemar test, The areas under the receiver operating characteristic curve (ROC) curve (AUC) of each RA classification criteria were analyzed using MedCalc software. Results A total of 310 patients were enrolled in this study, including 182 ERA and 128 non-RA. The sensitivity(88.5%) of ERA criteria was much higher than that of the 1987 ACR criteria (45.6%, χ2=75.013, P 0.05). The specificity of ERA criteria (91.4%) of 2010 ACR/EULAR criteria (87.5%, χ2=1.8, P>0.05) was similar to that of the 1987 ACR criteria (96.1%, χ2=3.1, P>0.05). The AUC of ERA criteria was 0.962 [95%CI(0.934, 0.980)], which was slightly better than that of the 2010 ACR/EULAR criteria 0.959 [95%CI(0.931, 0.978)], Z=0.380, P=0.7038, and much higher than that of the 1987 ACR criteria 0.885 [95%CI (0.845, 0.919)], Z=4.517, P<0.01. Conclusion Overall evaluation, the diagnostic value of ERA criteria is better than 1987 ACR and 2010 ACR/EULAR criteria in early rheumatoid arthritis. Compared to 2010 ACR/EULAR classification criteria, ERA criteria is more simple and practical. Key words: Arthritis, rheumatoid; Diagnosis; Reference standards