Anti-CCP antibodies have more diagnostic impact than rheumatoid factor (RF) in a population tested for RF
| Autor: | C. A. von Muhlen, R. W. Burlingame, Henrique Luiz Staub, Inês Guimarães da Silveira, Ana Lígia Bender |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
musculoskeletal diseases
Male medicine.medical_specialty Time Factors Population Gastroenterology Peptides Cyclic Sensitivity and Specificity Antibodies Arthritis Rheumatoid Rheumatology Predictive Value of Tests Rheumatoid Factor Internal medicine medicine Odds Ratio Rheumatoid factor Cutoff Humans Prospective Studies skin and connective tissue diseases Prospective cohort study education Aged Probability education.field_of_study Likelihood Functions Models Statistical business.industry General Medicine Odds ratio Middle Aged medicine.disease Surgery Rheumatoid arthritis Predictive value of tests Female business |
| Zdroj: | Clinical rheumatology. 26(11) |
| ISSN: | 0770-3198 |
| Popis: | To compare the diagnostic powers of rheumatoid factor (RF) and anti-cyclic citrullinated peptide (CCP) in a population selected for its high statistical relevance, over a 6-month period, an informed consent to test for anti-CCP was obtained from 1,025 consecutive patients for whom RF was ordered at a University laboratory. Within 1 year, a diagnosis was obtained without informing the physician about the anti-CCP result. Extensive statistical analyses were performed. A total of 768 patients satisfied the inclusion criteria, and 132 were classified as having RA, yielding a pre-test probability of RA of 17%. The sensitivities for anti-CCP and RF were 62 and 64% (P = 0.83), and the specificities were 97 and 90% (P < 0.001), respectively. The positive predictive value (PPV) was 79% for anti-CCP and 56% for RF (P < 0.001), whereas the negative predictive value was 92% for both. The likelihood ratio (LR) was 17.9 for anti-CCP and 6.2 for RF (P < 0.005). Forty RA patients were diagnosed with RA of less than 2 years length, and the same significant statistic differences between anti-CCP and RF were observed. Placing the results of both tests together, or using different cutoff points, increased the diagnostic utility of the tests. The anti-CCP test has statistically shown significant higher specificity, PPV, and LR for RA than the RF test in a clinically diverse population. If new criteria are to be devised to help diagnose early RA, anti-CCP should be included because it has a greater diagnostic impact than RF. |
| Databáze: | OpenAIRE |
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