title: Utility of the new rheumatoid arthritis 2010 ACR/EULAR classification criteria in routine clinical care.
abstract: OBJECTIVE
  The new 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria for rheumatoid arthritis (RA) have been designed to classify early onset RA, but has not been studied to identify RA in patients with arthritis seen in routine clinical care where correct 'classification' of patients, when they are not selected for having RA would be important.
  
  
  METHODS
  Prospective, consecutive patients cohort.
  
  
  METHODS
  Outpatient clinic of a university rheumatology centre.
  
  
  METHODS
  A total of 126 patients with joint symptoms were consecutively recruited.
  
  
  METHODS
  The ACR/EULAR RA criteria were applied, with questions followed by a targeted musculoskeletal exam. The gold standard for the diagnosis of RA was the primary rheumatologist's diagnosis.
  
  
  METHODS
  Number of patients with non-RA diagnosis who were classified as having RA by the new classification criteria.
  
  
  RESULTS
  The sensitivity and specificity of the 2010 criteria in classifying RA were 97% and 55%, respectively, compared with the 1987 RA criteria which were 93% and 76%, respectively. The 2010 criteria as applied to this group of patients had a poorer positive predictive (44% vs 61%) and a similar negative predictive value (98% vs 97%) compared with the 1987 criteria. More specifically, 66.7% of systemic lupus erythematosus patients, 50% of osteoarthritis, 37.5% of psoriatic arthritis and 27.2% of others fulfilled the new criteria and could have been classified as RA.
  
  
  CONCLUSIONS
  In this, we believe, the first study to examine the new 2010 ACR/EULAR RA criteria among consecutive patients seen in routine care, we found the criteria to have low specificity, and therefore incorrectly label those as having RA when, in fact, they may have a different type of inflammatory arthritis. Physicians need to be aware of this when applying the new criteria for classifying their patients for any purpose.
authors.affiliation: Division of Rheumatology, NYU Hospital for Joint Diseases, New York, New York USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Kennish
authors.forename: Monalyn
authors.initials: M
authors.lastname: Labitigan
authors.forename: Sam
authors.initials: S
authors.lastname: Budoff
authors.forename: Maria T
authors.initials: MT
authors.lastname: Filopoulos
authors.forename: W Andrew
authors.initials: WA
authors.lastname: McCracken
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Swearingen
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Yazici