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Rheumatology Advance Access originally published online on January 10, 2007
Rheumatology 2007 46(5):725-726; doi:10.1093/rheumatology/kel418
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© The Author 2007. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

EDITORIALS

Classification criteria for rheumatoid arthritis—time to abandon rheumatoid factor?

D. P. M. Symmons

ARC Epidemiology Unit, Stopford Building, University of Manchester, Oxford Road, Manchester M13 9PT, UK

Correspondence to: deborah.symmons@manchester.ac.uk

The first 150 words of the full text of this article appear below.

The 1987 classification criteria for rheumatoid arthritis (RA) [1] are nearly 20 yrs old. Ever since they were introduced, there have been rumblings of discontent. Predominantly there has been a concern that they do not perform well in the context of early inflammatory arthritis [2, 3]. This lack of sensitivity in early disease was acknowledged in the original paper. The criteria were developed by an analytical approach using data from patients attending specialist clinics for RA who had an average disease duration of over 7 yrs. The comparison group of patients had other established diagnoses such as osteoarthritis, fibromyalgia and lupus. They did not have early undifferentiated arthritis. As with almost all criteria sets in rheumatology, the 1987 ACR criteria use the ‘physician's opinion’ as the gold standard. The problem with early RA is that the physician cannot recognize it on clinical grounds alone. In . . . [Full Text of this Article]


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