How can misclassification be prevented when using the 2010 American College of Rheumatology/European League Against Rheumatism rheumatoid arthritis classification criteria? Comment on the article by van der Linden et al.

摘要

The 2010 American College of Rheumatology (ACR)/ European League Against Rheumatism (EULAR) criteria were developed to facilitate the early recognition of rheumatoid arthritis (RA) and to achieve increased sensitivity and specificity, compared to the 1987 ACR criteria, for identifying RA in an early phase (1,2). At the time of publication, the diagnostic and discriminative abilities of these new criteria were not known. In addition, it is unclear how the 2010 ACR/EULAR criteria perform in relation to the 1987 ACR criteria. Therefore, van der Linden et al performed a study to evaluate the differences in classification between the 1987 ACR criteria and the 2010 criteria in an early arthritis cohort and to determine the test characteristics of the 2010 criteria (3). They found that the sensitivity and specificity of the 2010 criteria were 0.84 and 0.60, respectively, using methotrexate (MTX) therapy as the outcome, and 0.74 and 0.74, respectively, using disease-modifying antirheumatic drug (DMARD) therapy as the outcome.