title: Application of the 2010 ACR/EULAR classification criteria in patients with very early inflammatory arthritis: analysis of sensitivity, specificity and predictive values in the SAVE study cohort.
abstract: OBJECTIVE
  Performance of the 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) rheumatoid arthritis (RA) criteria was analysed in an internationally recruited early arthritis cohort (≤16 weeks symptom duration) enrolled in the 'Stop-Arthritis-Very-Early' trial. This sample includes patients with a variety of diseases diagnosed during follow-up.
  
  
  METHODS
  Two endpoints were defined: Investigators' diagnosis and disease-modifying antirheumatic drug (DMARD) treatment start during the 12-month follow-up. The 2010 criteria were applied to score Patients' baseline data. Sensitivity, specificity, predictive values and areas under the receiver operating curves of this scoring with respect to both endpoints were calculated and compared to the 1987 criteria. The optimum level of agreement between the endpoints and the 2010 classification score ways estimated by Cohen's ϰ coefficients.
  
  
  RESULTS
  303 patients had 12-months follow-up. Positive predictive values of the 2010 criteria were 0.68 and 0.71 for RA-diagnosis and DMARD-start, respectively. Sensitivity for RA-diagnosis was 0.85, for DMARD-start 0.8, whereas the 1987 criteria's sensitivities were 0.65 and 0.55. The areas under the receiver operating curves of the 2010 criteria for RA-diagnosis and DMARD-start were 0.83 and 0.78. Analysis of inter-rater-agreement using Cohen's ϰ demonstrated the highest ϰ values (0.5 for RA-diagnosis and 0.43 for DMARD-start) for the score of 6.
  
  
  CONCLUSIONS
  In this international very early arthritis cohort predictive and discriminative abilities of the 2010 ACR/EULAR classification criteria were satisfactory and substantially superior to the 'old' 1987 classification criteria. This easier classification of RA in early stages will allow targeting truly early disease stages with appropriate therapy.
authors.affiliation: Department of non-coronarogenic Heart Disease and Clinical Rheumatology, NSC Institute of Cardiology, Kiev, Ukraine.
authors.forename: Iuliia
authors.initials: I
authors.lastname: Biliavska
authors.forename: Tanja A
authors.initials: TA
authors.lastname: Stamm
authors.forename: Jose
authors.initials: J
authors.lastname: Martinez-Avila
authors.forename: Thomas W J
authors.initials: TW
authors.lastname: Huizinga
authors.forename: Robert B M
authors.initials: RB
authors.lastname: Landewé
authors.forename: Günter
authors.initials: G
authors.lastname: Steiner
authors.forename: Daniel
authors.initials: D
authors.lastname: Aletaha
authors.forename: Josef S
authors.initials: JS
authors.lastname: Smolen
authors.forename: Klaus P
authors.initials: KP
authors.lastname: Machold
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use; D019540:Area Under Curve; D001172:Arthritis, Rheumatoid / Q000145:classification* / Q000175:diagnosis* / Q000188:drug therapy; D015331:Cohort Studies; D004311:Double-Blind Method; D042241:Early Diagnosis; D023381:Endpoint Determination; D005189:False Positive Reactions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D018501:Antirheumatic Agents