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Task force members rated their agreement with each recommendation from 0 (total disagreement) to
10 (total agreement). Meta-analysis of diagnostic properties (SROC curves) Heterogeneity was not
detected: the parameter. The etiology of Rheumatoid arthritis is unknown, however according to
medical reports and studies, the main factors that contribute to the development of RA include the
genetic and individual risk factors or prolonged exposure to environmental triggers. Third, the
predictive value of each criterion could not be assessed as the number of patients with RA and
controls was predefined. This review summarizes the pathogenesis-related rationales for the current
therapeutic strategies in RA and for emerging therapies and potential approaches to restoring
immune tolerance in RA. Finally, we turn to the emerging fields of bioengineering and cell therapy to
illuminate possible future targeted therapeutic options that combine material and biological sciences
for localized therapeutic action with the poten. Synovial fluid analysis is a very important tool to
distinguish RA from crystal-induced arthritis such as gout. Two study designs are possible to assess
diagnostic properties of scores: cross sectional (eg, this study) or longitudinal (ie, to assess at baseline
the criteria and at follow-up the final diagnosis, gold standard). Development and evaluation of
fuzzy criteria for diagnosis of rheumatoid arthritis. Modesto dos Santos V, Cezar BF, Barbosa ER Jr,
Carvalho FR. The ARA 1987 revised criteria select patients with clinical rheumatoid arthritis from a
population based cohort of subjects with chronic rheumatic diseases registered for drug
reimbursement. A meta-analysis using a summary receiver operating characteristic (SROC) curve was
performed and pooled sensitivity and specificity were calculated with confidence intervals. This
point is at the intersection of the SROC curve and the line joining the points (0,1) and (1,0).
Traditional epidemiological approaches to determine if this negative association is underpinned by
genetic factors would test for reduced rates of one disorder in relatives of the other, but sufficiently
powered data sets are difficult to achieve. OpenUrl PubMed Web of Science Yang JL, Zhang NZ,
Dong Y, Jiang M, Tang FL, Hu DW, et al. Search strategy The search was conducted using electronic
databases (Medline, PubMed and Embase), and abstracts from 2005, 2006 and 2007 international
congresses including ACR and European League against Rheumatism congresses, with no limitations
by type of publications. Both diseases are also characterized by severe morning joint stiffness.
Determination of sensitivity and specificity Table 2 gives the final results for sensitivities and
specificities or ACR criteria for each study and pooled results according to the format of ACR 1987
criteria and the disease duration. Methods: A systematic review of existing literature was performed
using the Joanna Briggs Institute approach for the systematic review and Preferred Reporting Items
for Systematic Reviews and Meta-Analyses guidelines. In RA, the immune response will be
activated at an early stage of life possibly triggered by genetic and environmental factors. Second,
some of the patients in that evaluation had longstanding disease. Visser H, le Cessie S, Vos K,
Breedveld FC, Hazes JM. Combining independent studies of a diagnostic test into a summary ROC
curve: data-analytic approaches and some additional considerations. Clinical and radiographic
outcomes of four different treatment strategies in patients with early rheumatoid arthritis (the BeSt
study): a randomized, controlled trial. A cross-sectional and longitudinal comparison of the Rome
criteria for active rheumatoid arthritis (equivalent to the American College of Rheumatology 1958
criteria) and the American College of Rheumatology 1987 criteria for rheumatoid arthritis. Our 100%
online process takes only a few minutes of patients time and a licensed physician reviews your file
the same day. The use of doctors as the gold standard may perhaps explain the low sensitivity and
specificity of the 1987 ACR criteria: this conferred the advantage to the rheumatologist(s) who have
more information for accurate diagnosis such as family history, presence of a Felty syndrome,
positive squeeze test, etc. OpenUrl ? Jones CM, Athanasiou T, Dunne N, Kirby J, Aziz O, Haq A, et
al. The effect of a covariate is analysed by a classical test of the nullity of the corresponding
regression parameter. Using three languages ensured the search was exhaustive, even if finally all
studies were published in English.
In established RA, the higher specificity and higher log odds ratio of the tree format list criteria
clearly puts this test at an advantage over the list format. An attack of acute gouty arthritis is caused
by the formation of needlelike crystals of the deposited uric acid. It should be noted that the
sensitivity analysis excluding Harrison’s study indicated similar results, although the difference
between performances in early and late disease then became non-significant. Articles were excluded
if they did not concern adult RA or if they did not report any PROs. (2) Data extraction:
demographic characteristics of patients, study design, treatment assessed and all PROs. (3) Data
analysis: descriptive. Fourth, the controls had a variety of disorders, some of which were readily
distinguishable from RA such as osteoarthritis or fibromyalgia, which may have led to
overestimation of the specificity of the criteria. A panel of doctors might have improved the
uniformity of the final diagnosis retained. 7 The choice of a gold standard is often a delicate point in
diagnostic meta-analyses. The difference between early RA and established RA as defined arbitrarily
here was not always strictly respected. Indeed, two sensitivity analyses for the ACR 1987 criteria in
list format were performed dropping the studies leading to an asymmetric funnel plot (one analysis
dropping the three studies with the highest sample size, and another one dropping the study with the
lowest diagnostic performances). The SROC meta-analysis confirmed the statistically significant
differences, suggesting that diagnostic performances of ACR list criteria are better in established
arthritis. However, the traditional list format is easier to use in clinical practice. In order to develop
novel treatment for RA, a range of strategies needs to be developed which primarily shall focus on
those patients who do not respond to available drugs, including biologics, that are being explored
currently. Thornton Wayland Baptist Rheumatoid arthritis is often treated with anti-inflammatory
medications and prescribed pharmaceuticals. Covariates can be introduced in the regression model.
Synovial fluid analysis is a very important tool to distinguish RA from crystal-induced arthritis such
as gout. In this study, the duration of the disease was added in the model as a binary variable.
OpenUrl CrossRef PubMed Web of Science Hulsemann JL, Zeidler H. A multidisciplinary task
force, representing 10 European countries, formulated a definition for PE and 10 research questions
that guided a systematic literature review (SLR). Evaluation of the 1987 revised ARA criteria for
rheumatoid arthritis: a retrospective analysis of Japanese patients with rheumatoid arthritis and other
rheumatic diseases. In particular, Harrison’s study 12 appears to be an “outlier” in terms of
sensitivity and specificity, although this study was of good methodological quality. The 1958 and
1987 ARA revised criteria for rheumatoid arthritis in Chinese patients. A cross-sectional and
longitudinal comparison of the Rome criteria for active rheumatoid arthritis (equivalent to the
American College of Rheumatology 1958 criteria) and the American College of Rheumatology 1987
criteria for rheumatoid arthritis. The 41-year-old construction worker sustained a spinal injury that
left him with arthritis on the inside of his spinal column causing him pain, frustration, and
depression. Both the prospective studies were conducted among Americans, whose general dietary
habits differ substantially from a traditional Mediterranean diet, and individuals with the highest
adherence score may still not resemble the traditional Mediterranean diet. Being overweight or
drinking too much alcohol can be a reason for gout to develop. It can also produce diffuse
inflammation in the lungs, pericardium, pleura, and the sclera of the eye, and also nodular lesions,
most common in subcutaneous tissue. Despite advances in targeted biologic and pharmacologic
interventions that have recently come to market, many patients with RA continue to have inadequate
response to therapies, or intolerable side effects, with resultant progression of their disease. This
should allow the diagnostic value of each clinical, radiological, biological and exclusion criterion to
be assessed. Conclusions: PROs are reported with great heterogeneity in recently published trials in
RA. Decision-tree format of 1987 American College of Rheumatology criteria for the classification
of rheumatoid arthritis (RA). It is an only prescription drug and is available for individuals who have
tenderness, swelling and pain caused by the inflammation of osteoarthritis, rheumatoid arthritis or
ankylosing spondylitis.
The ARA 1987 revised criteria select patients with clinical rheumatoid arthritis from a population
based cohort of subjects with chronic rheumatic diseases registered for drug reimbursement. To
browse Academia.edu and the wider internet faster and more securely, please take a few seconds to
upgrade your browser. OpenUrl PubMed Web of Science MacGregor AJ, Bamber S, Silman AJ. In
particular, Harrison’s study 12 appears to be an “outlier” in terms of sensitivity and specificity,
although this study was of good methodological quality. In order to develop novel treatment for
RA, a range of strategies needs to be developed which primarily shall focus on those patients who do
not respond to available drugs, including biologics, that are being explored currently. OpenUrl
PubMed Web of Science Yang JL, Zhang NZ, Dong Y, Jiang M, Tang FL, Hu DW, et al.
Rheumatoid arthritis (RA) was regarded as a major clinical problem, however treatments involving
biologics have revolutionized the management of this inflammatory disease. Thus, Jacobsson et al
reported in their study a 28% sensitivity of “ACR criteria but NOT Rome criteria” if applied “cross
sectionally” versus 64.6% if applied “cumulatively”. 18 Finally, a better selection of the control
groups may also improve specificity as suggested by Levin et al 13: using only patients with arthritis
represents a fair test, since patients in this group are those whose diagnosis is most likely to be
confused with RA. A comparison of the performance of different methods of disease classification
for rheumatoid arthritis. Finally, some articles were analysed even when their aim was not to
evaluate sensitivity or specificity of ACR 1987 criteria. All these differences may explain the wide
range of sensitivity and specificity reported, as shown in fig 3. The results from the SLR were
discussed and used as a basis for developing the recommendations, a research agenda and an
educational agenda. To browse Academia.edu and the wider internet faster and more securely, please
take a few seconds to upgrade your browser. Download Free PDF View PDF See Full PDF
Download PDF Loading Preview Sorry, preview is currently unavailable. The performance of the
1987 ARA classification criteria for rheumatoid arthritis in a population based cohort of patients
with early inflammatory polyarthritis. The first page of the PDF of this article appears above. The
inflammatory process may involve the heart and produce rheumatic heart disease. In established RA,
the higher specificity and higher log odds ratio of the tree format list criteria clearly puts this test at
an advantage over the list format. In all, the shape of the funnel plot suggested a bias due to the
study size. You will be able to get a quick price and instant permission to reuse the content in many
different ways. The objective of this study was to assess the frequency of use of different PROs in
recently published RA articles and to compare the tools used through a systemic literature review.
Frequently reported domains (and most frequent tools) were: function, 83% (most frequent tool,
health assessment questionnaire, HAQ); patient global assessment, 61% (most frequent tool, visual
analogue scale, VAS); pain, 56% (VAS); and morning stiffness 27%. Rheumatol Int, 2018. 38(5): p.
737-747. One-sentence summary: There was insufficient evidence to support the use of the
Mediterranean Diet for the prevention of rheumatoid arthritis, but it may provide some benefit for
the progression of rheumatoid arthritis. Acknowledgments: Khalid Almutairi was supported by an
Australian Government Research Training Program PhD Scholarship at the University of Western
Australia (UWA). Domains such as fatigue, coping or sleep disturbance were infrequently reported.
Results: Of 138 publications initially identified, 19 were analysable (total 7438 patients, 3883 RA).
Heterogeneity was detected (Cochran Q test; p Figure 4 represents graphically the meta-analysis of
sensitivities and specificities. REFERENCES ? Mottonen T, Hannonen P, Leirisalo-Repo M, Nissila
M, Kautiainen H, Korpela M, et al. A review of assignment criteria for rheumatoid arthritis. The
results of rheumatoid arthritis are pain, swelling, stiffness and bone.
Meta-analyses of diagnostic tests: a review of methods for SROC curves assessment. To browse
Academia.edu and the wider internet faster and more securely, please take a few seconds to upgrade
your browser. This review summarizes the pathogenesis-related rationales for the current therapeutic
strategies in RA and for emerging therapies and potential approaches to restoring immune tolerance
in RA. Conclusions: PROs are reported with great heterogeneity in recently published trials in RA.
These results may be used as a basis when assessing new diagnostic criteria in RA. Population: Two
of the studies were in Sweden, one in the United States and one in Scotland. OpenUrl ? Jones CM,
Athanasiou T, Dunne N, Kirby J, Aziz O, Haq A, et al. Quality assessment: Clinical trials were
evaluated using the Cochrane Collaboration’s tool and the prospective studies were evaluated using
the National Heart, Lung, and Blood Institute’s quality assessment tool. Thus, Jacobsson et al
reported in their study a 28% sensitivity of “ACR criteria but NOT Rome criteria” if applied “cross
sectionally” versus 64.6% if applied “cumulatively”. 18 Finally, a better selection of the control
groups may also improve specificity as suggested by Levin et al 13: using only patients with arthritis
represents a fair test, since patients in this group are those whose diagnosis is most likely to be
confused with RA. Johnson SR, Goek ON, Singh-Grewal D, Vlad SC, Feldman BM, Felson DT, et
al. Current conventional and biological therapies used for RA are not fulfilling the need of the
patients but give only partial r. Meta-analysis of diagnostic properties (SROC curves) Heterogeneity
was not detected: the parameter. Chief Complaint: Swelling of the lips, causing difficulty
swallowing. The doctors are expected to diagnose RA based on clinical, biological and radiological
examinations; there may of course be some interference with the ACR criteria as these are widely
used and widely known. The recommendations were categorised according to level and strength of
evidence graded from A (highest) to D (lowest). Frequently reported domains (and most frequent
tools) were: function, 83% (most frequent tool, health assessment questionnaire, HAQ); patient
global assessment, 61% (most frequent tool, visual analogue scale, VAS); pain, 56% (VAS); and
morning stiffness 27%. The systematic literature review was performed according to Cochrane
Collaboration recommendations. You can download the paper by clicking the button above. The three
studies with a large sample size (more than 400 subjects) were all in the far right part of the plot,
indicating they had higher diagnostic performances. Methods: A systematic review of existing
literature was performed using the Joanna Briggs Institute approach for the systematic review and
Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The purpose of
this study was to survey the serum level of vitamin D in patients suffering from rheumatoid arthritis
and its relationship with the activity of the disease. Clonal deletion of auto reactive cells remains the
central canon of immunology for decades, keeping the role of T cell and B cell aside, which are
actually the guards to recognize the entry of foreign body. Furthermore, the gold standard using
expert opinion was based on one or several doctors’ diagnosis. OpenUrl PubMed Leitich H,
Adlassnig KP, Kolarz G. However, both her daughter and her husband are also living with chronic
medicals condition making the family dynamic complex. OpenUrl CrossRef Chogle AR, Desai BH,
Jhankaria GR. Some domains that appear important from the patient’s perspective are infrequently
reported. The following data were collected in all studies: definition of RA (gold standard used),
number of patients with RA and controls, diagnosis of control patients, distribution of patients
between patients with RA (by gold standard) and controls, according to ACR 1987 criteria in list
format and tree format, patient characteristics (rheumatoid factor positivity, specific x -ray changes)
and disease duration. Pooled sensitivity and specificity were separately assessed by using the arcsin
transformed proportions. 31 Heterogeneity was tested with the Cochran Q statistic, and in cases of
heterogeneity a random effect model was used. 32 Ninety-five per cent confidence intervals (CIs)
are given as (lower limit to upper limit). Two study designs are possible to assess diagnostic
properties of scores: cross sectional (eg, this study) or longitudinal (ie, to assess at baseline the
criteria and at follow-up the final diagnosis, gold standard).
This should allow the diagnostic value of each clinical, radiological, biological and exclusion
criterion to be assessed. A search of ProQuest, MEDLINE, Web of Science, and EMBASE was
undertaken to include population-based studies investigating RA prevalence between 1980 and 2019.
However, these diagnostic criteria have not been validated and are not widely used in clinical
practice. Other reviews: Smedslund, G., et al., Effectiveness and safety of dietary interventions for
rheumatoid arthritis: a systematic review of randomized controlled trials. Bias in meta-analysis
detected by a simple, graphical test. Meta-analysis of diagnostic properties (SROC curves)
Heterogeneity was not detected: the parameter. Because of this “window of opportunity”, it is
essential to re-evaluate existing diagnostic tools to better identify subjects with RA for early
treatment and for inclusion in clinical trials. The join inflammation of rheumatoid arthritis causes
swelling, pain,stiffness, and redness in the joints. Results: Sixty published population-based studies
met the inclusion criteria over the study period. How to diagnose rheumatoid arthritis early: a
prediction model for persistent (erosive) arthritis. Results of an analysis from a nationwide twin
study. To address the many problems with rheumatology care in India, curricular reforms, capacity
building, patient education and political support are sorely needed. To browse Academia.edu and the
wider internet faster and more securely, please take a few seconds to upgrade your browser. Several
continents were represented, reflecting good representativity. Evaluation of the 1987 revised ARA
criteria for rheumatoid arthritis: a retrospective analysis of Japanese patients with rheumatoid arthritis
and other rheumatic diseases. ACR 1987 criteria were assessed both in list format and in tree format,
as available. This poor prognosis has led to an emphasis on rapid introduction of aggressive treatment
by disease-modifying antirheumatic drugs. 1 For this purpose, it is important to have diagnostic
criteria which could, at an early stage of the disease, determine the diagnosis of RA, thus allowing
rapid introduction of these drugs. Case Study Rubric: All questions on the case study completed in a
clear and insightful manner. A free text search was conducted using the following key word
combination: (“ACR rheumatoid arthritis criteria” or “ACR 1987” or “ARA 1987”) and
“sensitivity”. In all, the shape of the funnel plot suggested a bias due to the study size. OpenUrl
CrossRef PubMed Web of Science Hulsemann JL, Zeidler H. Task force members rated their
agreement with each recommendation from 0 (total disagreement) to 10 (total agreement). At least
four criteria must be fulfilled for classification as RA The objective of this study was to assess
through a systematic literature review, the diagnostic capacity (sensitivity and specificity) of the
ACR 1987 RA classification criteria, for the diagnosis of RA, according to disease duration, and to
perform a meta-analysis of these diagnostic capacities by receiver operator curves. She denies injury
or other initiating events that might explain the signs and symptoms. Having the patients as involved
as possible in their own care allows them to take back some of the power that health care can take
away. In this review, we detail multiple biomolecular pathways involved in RA disease pathogenesis
to elucidate and highlight pathways that have been therapeutic targets in managing this systemic
autoimmune disease. Conclusion: The specificity of ACR 1987 criteria in early RA is low, and these
criteria should not be used as diagnostic tools. The doctors are expected to diagnose RA based on
clinical, biological and radiological examinations; there may of course be some interference with the
ACR criteria as these are widely used and widely known. In addition, criteria 5, 6 and 7 of the ACR
1987 list criteria ( table 1 ) are not often fulfilled in the first year after the onset of RA and may
therefore lack sensitivity in early RA. Accurate RA prevalence data are required to plan preventative,
diagnostic, and management strategies to address raising health care service demands and costs
associated with improved lifespan and level of disability (5, 6). Sensitivity and specificity of ACR
criteria for the diagnosis of RA were calculated against the gold standard of expert opinion in all
analysed studies.
Because of this “window of opportunity”, it is essential to re-evaluate existing diagnostic tools to
better identify subjects with RA for early treatment and for inclusion in clinical trials. Frequently
reported domains (and most frequent tools) were: function, 83% (most frequent tool, health
assessment questionnaire, HAQ); patient global assessment, 61% (most frequent tool, visual
analogue scale, VAS); pain, 56% (VAS); and morning stiffness 27%. Ligaments connect the bones
and keep the joint stable. Calcium pyrophosphate dihydrate crystal deposition disease and primary
hyperparathyroidism associated with rheumatoid arthritis: description of 3 cases. Besides auto-
antibodies, several other factors are involved in the progression of RA, such as epigenetic alterations,
post-translational modifications, glycosylation, autophagy, and T-cells. Covariates can be introduced
in the regression model. Accurate RA prevalence data are required to plan preventative, diagnostic,
and management strategies to address raising health care service demands and costs associated with
improved lifespan and level of disability (5, 6). The objective of this study was to assess the
frequency of use of different PROs in recently published RA articles and to compare the tools used
through a systemic literature review. In RA the underlying objective of using therapeutics is to
reduce the activity of this disease with the main aim focussing on disease remission. These results
suggest these criteria should not be used as a diagnosis tool in short duration disease. It can also
produce diffuse inflammation in the lungs, pericardium, pleura, and the sclera of the eye, and also
nodular lesions, most common in subcutaneous tissue. At least four criteria must be fulfilled for
classification as RA The objective of this study was to assess through a systematic literature review,
the diagnostic capacity (sensitivity and specificity) of the ACR 1987 RA classification criteria, for
the diagnosis of RA, according to disease duration, and to perform a meta-analysis of these
diagnostic capacities by receiver operator curves. Understanding the interplay between these factors
would contribute to a deeper insight into the causes, mechanisms, progression, and treatment of the.
Jacobsson LT, Knowler WC, Pillemer S, Hanson RL, Pettitt DJ, McCance DR, et al. Chief
Complaint: Swelling of the lips, causing difficulty swallowing. However, both her daughter and her
husband are also living with chronic medicals condition making the family dynamic complex.
Methods: A systematic review of existing literature was performed using the Joanna Briggs Institute
approach for the systematic review and Preferred Reporting Items for Systematic Reviews and
Meta-Analyses guidelines. It may be time to revise the 1987 ACR classification criteria for RA to
take into account changes which have appeared during the past 20 years, and to develop more
sensitive criteria for diagnosis of early RA. Some modifications in the ACR 1987 criteria may be
indicated. The doctors are expected to diagnose RA based on clinical, biological and radiological
examinations; there may of course be some interference with the ACR criteria as these are widely
used and widely known. In RA, the immune response will be activated at an early stage of life
possibly triggered by genetic and environmental factors. Conclusion: The specificity of ACR 1987
criteria in early RA is low, and these criteria should not be used as diagnostic tools. This review
summarizes the pathogenesis-related rationales for the current therapeutic strategies in RA and for
emerging therapies and potential approaches to restoring immune tolerance in RA. Classification
criteria for rheumatoid arthritis—time to abandon rheumatoid factor. Current conventional and
biological therapies used for RA are not fulfilling the need of the patients but give only partial r. Key
results: Risk of developing rheumatoid arthritis: No significant association with the Mediterranean
diet (2 of 2 studies found no association). Chronic inflammation in the synovium and pannus
formation leads to destruction of the cartilage and bone in RA. Data collection The analysis of each
manuscript was standardised using a predetermined list by one reader (FB). The use of doctors as
the gold standard may perhaps explain the low sensitivity and specificity of the 1987 ACR criteria:
this conferred the advantage to the rheumatologist(s) who have more information for accurate
diagnosis such as family history, presence of a Felty syndrome, positive squeeze test, etc. A funnel
plot was performed to give visual indications for bias in the studies selected for the meta-analysis. 33
RESULTS Of the 138 publications identified, 19 articles reported interpretable data and were
included in the analysis—that is, a total of 7438 patients ( fig 2 ).
In this review, we detail multiple biomolecular pathways involved in RA disease pathogenesis to
elucidate and highlight pathways that have been therapeutic targets in managing this systemic
autoimmune disease. Both the prospective studies were classified as a moderate risk of bias, whilst
the controlled clinical trial and the randomised controlled trial were assessed as a high overall risk
and a moderate overall risk of bias respectively. A cross-sectional and longitudinal comparison of the
Rome criteria for active rheumatoid arthritis (equivalent to the American College of Rheumatology
1958 criteria) and the American College of Rheumatology 1987 criteria for rheumatoid arthritis. The
first page of the PDF of this article appears above. A comparison of the performance of different
methods of disease classification for rheumatoid arthritis. To browse Academia.edu and the wider
internet faster and more securely, please take a few seconds to upgrade your browser. This point is at
the intersection of the SROC curve and the line joining the points (0,1) and (1,0). Based on the SLR
and expert opinions, eight recommendations were developed, four with strength A evidence. Other
reviews: Smedslund, G., et al., Effectiveness and safety of dietary interventions for rheumatoid
arthritis: a systematic review of randomized controlled trials. Acknowledgments: Khalid Almutairi
was supported by an Australian Government Research Training Program PhD Scholarship at the
University of Western Australia (UWA). Third, the predictive value of each criterion could not be
assessed as the number of patients with RA and controls was predefined. Articles reporting the
American College of Rheumatology (ACR) 1987 criteria diagnostic capacity in rheumatoid arthritis
(RA). Etiology and Pathogenesis Rheumatoid arthritis is a prevalent category of arthritis with
unknown causes; however, researchers suspect that viruses, bacteria, and fungi cause it. In addition,
criteria 5, 6 and 7 of the ACR 1987 list criteria ( table 1 ) are not often fulfilled in the first year after
the onset of RA and may therefore lack sensitivity in early RA. In addition, references of the papers
initially detected were hand searched to identify additional relevant reports. All these differences
may explain the wide range of sensitivity and specificity reported, as shown in fig 3. The
inflammatory process may involve the heart and produce rheumatic heart disease. The main aim of
writing this review is to give a strong knowledge about the epidemiology, risk factors, clinical
manifestations, diagnosis and a few of the many treatment strategies currently being evaluated,
which are hoped to lead to greater benefits and better disease management in the clinical setting. The
environment, geo-epidemiology, and autoimmune disease: Rheumatoid arthritis. In established
arthritis, sensitivity and specificity were respectively 79% (71% to 85%) and 90% (84% to 94%)
versus 80% (71% to 85%) and 93% (86% to 97%). Development and evaluation of fuzzy criteria for
diagnosis of rheumatoid arthritis. In total, 3555 patients were included as controls in order to assess
the set of ACR 1987 criteria. SROC curves are a validated method to perform meta-analyses of
diagnostic properties, 29 and a separate meta-analysis was performed to obtain pooled sensitivity and
specificity values. The Medline search was last updated on 31 December 2007 and the Embase search
was performed on 10 April 2007. As biomarkers, they could help to make a more efficient diagnosis,
prognosis, and treatment decision. In this study, the duration of the disease was added in the model
as a binary variable. All articles reporting the prevalence of RA according to ACR criteria and expert
opinion in cohorts of early ( 1 year) arthritis were analysed to calculate the sensitivity and specificity
of ACR 1987 criteria against the “gold standard” (expert opinion). A meta-analysis using a summary
receiver operating characteristic (SROC) curve was performed and pooled sensitivity and specificity
were calculated with confidence intervals. The following data were collected in all studies: definition
of RA (gold standard used), number of patients with RA and controls, diagnosis of control patients,
distribution of patients between patients with RA (by gold standard) and controls, according to ACR
1987 criteria in list format and tree format, patient characteristics (rheumatoid factor positivity,
specific x -ray changes) and disease duration. Levin RW, Park J, Ostrov B, Reginato A, Baker DG,
Bomalaski JS, et al.