Performance of the 2010 ACR/EULAR classification criteria for rheumatoid arthritis: a systematic literature review
Performance of the 2010 ACR/EULAR classification criteria for rheumatoid arthritis: a systematic literature review
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DOI：
10.1136/annrheumdis-2013-203284
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发表时间：
2014-01-01
影响因子：
27.4
通讯作者：
Aletaha, Daniel
中科院分区：
文献类型：
--
作者：
Radner, Helga;Neogi, Tuhina;Aletaha, Daniel
背景 制定 2010 年 ACR/EULAR 类风湿关节炎 (RA) 分类标准是为了提高 RA 研究个体的识别能力。我们的目的是根据已发表的文献总结标准的表现。方法我们进行了系统的文献检索，以确定调查 2010 年标准的所有研究和报告数据，以便计算敏感性 (SENS)、特异性 (SPEC) 以及阳性和阴性预测值。在可能的情况下，进行荟萃分析。结果 17 篇全文（总共 6816 名患者）和 17 篇会议摘要（总共 4004 名患者）符合纳入标准。 RA 的汇总敏感性和特异性（由不同参考标准定义）分别为 0.82 (95% CI 0.79-0.84) 和 0.61 (0.59-0.64)。不同参考标准的结果具有可比性：开始甲氨蝶呤的汇总敏感性为 0.85 (0.83-0.86)，特异性为 0.52 (0.49-0.54)；对于任何疾病缓解抗风湿药物的起始治疗，它们分别为 0.80 (0.79-0.82) 和 0.65 (0.61-0.68)；专家意见为 0.88 (0.86-0.90) 和 0.48 (0.35-0.52)。使用不同类型的关节计数没有观察到差异。八项研究和五项会议摘要直接比较了不同目标人群中使用不同参考标准的 1987 年和 2010 年标准，显示出较高的总体敏感性（与 1987 年标准相比 +0.11），但总体特异性较低（-0.04）。结论 2010 年 ACR/EULAR 标准发布两年后，已在社区中进行了广泛测试。它们对于检测不同目标人群中的 RA 病例非常敏感，无论后者如何被提及。
Background The 2010 ACR/EULAR classification criteria for rheumatoid arthritis (RA) were developed to improve the identification of individuals for studies of RA. We aimed to summarise the performance of the criteria based on the published literature.Methods We performed a systematic literature search to identify all studies investigating the 2010 criteria and reporting data allowing to calculate sensitivity (SENS), specificity (SPEC), and positive and negative predictive values. Where possible, meta-analysis was performed.Results Seventeen full articles (total 6816 patients) and 17 meeting abstracts (total 4004 patients) fulfilled the inclusion criteria. Pooled sensitivity and specificity for RA (defined by different reference standards) were 0.82 (95% CI 0.79-0.84) and 0.61 (0.59-0.64). Results were comparable for different reference standards: for initiation of methotrexate pooled sensitivity was 0.85 (0.83-0.86) and specificity was 0.52 (0.49-0.54); for initiation of any disease modifying antirheumatic drug they were 0.80 (0.79-0.82) and 0.65 (0.61-0.68), respectively; and for expert opinion 0.88 (0.86-0.90) and 0.48 (0.35-0.52). No differences were observed for use of different types of joint counts. Eight studies and five meeting abstracts directly compared 1987 and 2010 criteria using different reference standards within different target populations showing higher overall sensitivity (+0.11 compared with 1987 criteria) at the cost of lower overall specificity (-0.04).Conclusions Twoyears after their publication, the 2010 ACR/EULAR criteria have been widely tested in the community. They are sensitive to detect cases of RA among various target populations, independent of how the latter is referenced.