title: Diagnostic performance of the ACR/EULAR 2010 criteria for rheumatoid arthritis and two diagnostic algorithms in an early arthritis clinic (REACH).
abstract: BACKGROUND
  An ACR/EULAR task force released new criteria to classify rheumatoid arthritis at an early stage. This study evaluates the diagnostic performance of these criteria and algorithms by van der Helm and Visser in REACH.
  
  
  METHODS
  Patients with symptoms ≤12 months from REACH were used. Algorithms were tested on discrimination, calibration and diagnostic accuracy of proposed cut-points. Two patient sets were defined to test robustness; undifferentiated arthritis (UA) (n=231) and all patients including those without synovitis (n=513). The outcomes evaluated were methotrexate use and persistent disease at 12 months.
  
  
  RESULTS
  In UA patients all algorithms had good areas under the curve 0.79, 95% CI 0.73 to 0.83 for the ACR/EULAR criteria, 0.80, 95% CI 0.74 to 0.87 for van der Helm and 0.83, 95% CI 0.77 to 0.88 for Visser. All calibrated well. Sensitivity and specificity were 0.74 and 0.66 for the ACR/EULAR criteria, 0.1 and 1.0 for van der Helm and 0.59 and 0.93 for Visser. Similar results were found in all patients indicating robustness.
  
  
  CONCLUSIONS
  The ACR/EULAR 2010 criteria showed good diagnostic properties in an early arthritis cohort reflecting daily practice, as did the van der Helm and Visser algorithms. All were robust. To promote uniformity and comparability the ACR/EULAR 2010 criteria should be used in future diagnostic studies.
authors.affiliation: Department of Rheumatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Celina
authors.initials: C
authors.lastname: Alves
authors.forename: Jolanda Jacoba
authors.initials: JJ
authors.lastname: Luime
authors.forename: Derkjen
authors.initials: D
authors.lastname: van Zeben
authors.forename: Anne-Margriet
authors.initials: AM
authors.lastname: Huisman
authors.forename: Angelique Elisabeth Adriana Maria
authors.initials: AE
authors.lastname: Weel
authors.forename: Pieternella Johanna
authors.initials: PJ
authors.lastname: Barendregt
authors.forename: Johanna Maria Wilhelmina
authors.initials: JM
authors.lastname: Hazes
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000188:drug therapy; D042241:Early Diagnosis; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged
chemical_list: D018501:Antirheumatic Agents; D008727:Methotrexate