Background The 2010 ACR/EULAR classification criteria for rheumatoid arthritis (RA) were developed to improve the identification of individuals for studies of RA. We aimed to summarise the performance of the criteria based on the published literature. Methods We performed a systematic literature search to identify all studies investigating the 2010 criteria and reporting data allowing to calculate sensitivity (SENS), specificity (SPEC), and positive and negative predictive values. Where possible, meta-analysis was performed. Results Seventeen full articles (total 6816 patients) and 17 meeting abstracts (total 4004 patients) fulfilled the inclusion criteria. Pooled sensitivity and specificity for RA (defined by different reference standards) were 0.82 (95% CI 0.79–0.84) and 0.61 (0.59–0.64). Results were comparable for different reference standards: for initiation of methotrexate pooled sensitivity was 0.85 (0.83–0.86) and specificity was 0.52 (0.49–0.54); for initiation of any disease modifying antirheumatic drug they were 0.80 (0.79–0.82) and 0.65 (0.61–0.68), respectively; and for expert opinion 0.88 (0.86–0.90) and 0.48 (0.35–0.52). No differences were observed for use of different types of joint counts. Eight studies and five meeting abstracts directly compared 1987 and 2010 criteria using different reference standards within different target populations showing higher overall sensitivity (+0.11 compared with 1987 criteria) at the cost of lower overall specificity (–0.04). Conclusions Two years after their publication, the 2010 ACR/EULAR criteria have been widely tested in the community. They are sensitive to detect cases of RA among various target populations, independent of how the latter is referenced.

https://ard.bmj.com/content/annrheumdis/73/1/114.full.pdf

Performance of the 2010 ACR/EULAR classification criteria for rheumatoid arthritis: a systematic literature review

New classification criteria for rheumatoid arthritis (RA) were presented by the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) in 2010, aiming for early identification of patients at risk of developing persistent and erosive arthritis. Since their publication, the criteria have been extensively validated against several reference standards, but there is still debate regarding how the criteria should be implemented in studies and clinical care. We present an overview of the published validation studies and discuss the strengths and limitations of the classification criteria, as well as whether the criteria are ready for diagnostic purposes in clinical practice.

Early rheumatoid arthritis: The performance of the 2010 ACR/EULAR criteria for diagnosing RA

The 2010 ACR/EULAR criteria are not sufficiently accurate in the early identification of autoantibody-negative rheumatoid arthritis: Results from the Leiden-EAC and ESPOIR cohorts.

Objective: To compare application of the 1987 American College of Rheumatology (ACR) and 2010 ACR/European League Against Rheumatism (EULAR) classification criteria for diagnosing rheumatoid arthritis (RA) in clinical practiceMethod: The medical records of patients with early arthritis attending the Rheumatology Department, Umea University Hospital (n = 1026) were analysed Patients with synovitis in at least one joint, no diagnosis other than RA being better for explaining the synovitis, and duration of symptoms less than 1 year at first visit, and at least 1 year of follow-up were included consecutively Fulfilment of the 1987 and 2010 criteria at baseline was evaluated Sensitivity and specificity for each criterion set, where estimated by using the outcome measures: initiation of methotrexate (MTX) therapy during the first year, and a clinical diagnosis of RA at the 1-year follow-up Radiographs of hands and feet were evaluated using the Larsen scoreResults: The study included 313 patients, of whom 

Comparison of the 1987 ACR and 2010 ACR/EULAR classification criteria for rheumatoid arthritis in clinical practice : a prospective cohort study

Comparison of the 1987 ACR and 2010 ACR/EULAR Classification Criteria for Rheumatoid Arthritis in Clinical Practice

The aim of this study was to evaluate the 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria for rheumatoid arthritis (RA) in a cohort with early arthritis and true diagnosis confirmed by long-term follow-up. The criteria were tested in the Heinola community-based inception cohort of 121 true RA patients, while the control group consisted of 95 patients with definite spondyloarthritis and swollen joint(s), recruited in the same time. The diagnoses were confirmed by long-term follow-up. The fulfillment of the four 2010 criteria was determined at baseline (arthritis duration less than 6 months). Ninety-five in one hundred twenty-one (79%) of all RA patients, 54/68 (79%) of nonerosive (at baseline) RA patients, and 4/95 (4%) of controls fulfilled the 2010 criteria of RA, with better specificity (96%) than the 1987 ACR criteria (86%) in the same material. At baseline erosions were found in 44% of all RA patients and in 15% of the controls; rheumatoid factor was positive in 87% of the RA patients, but in 1% of the controls. One hundred seven in one hundred twenty-one (88%) of all RA patients and 16/95 (17%) of the controls fulfilled the 2010 total score criteria or were erosive at onset. The 2010 ACR/EULAR criteria should be documented in all patients with arthritis. If the criteria are not fulfilled at baseline in a nonerosive patient, the true diagnose may still be RA due to seroconversion or diagnostic manifestations during the follow-up. Indications for early disease modifying antirheumatic drug treatment may be present in active arthritis also in cases not fulfilling the new criteria at baseline.

The 2010 ACR/EULAR classification criteria for rheumatoid arthritis in the Heinola inception cohort—diagnoses confirmed by long-term follow-up

The debate whether an elevated level of serum uric acid (SUA) is an independent marker of cardiovascular risk is still going on. We examined morbidity and mortality related to SUA and hyperuricemia...

Long-term prognostic impact of hyperuricemia in community

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The 2010 ACR/EULAR classification criteria for rheumatoid arthritis in the Heinola inception cohort—diagnoses confirmed by long-term follow-up

Long-term prognostic impact of hyperuricemia in community

Long-term prognostic impact of hyperuricemia in community