Objective To compare the agreement between three classification criteria for early rheumatoid arthritis (ERA) in Shanxi Province of China. Methods Patients whose age was more than 16 years old, disease duration no more than 2 years, and at least one joint swelling and tenderness were enrolled in a multicenter, retrospective cohort. The patients were grouped as RA or non-RA with detailed clinical and laboratory parameters recorded. The sensitivity and specificity of these criteria were compared with McNemar, and the areas under the ROC curves (AUC) were analyzed with MedCalc. The level of agreement between the three classification criteria was analyzed with kappa coefficient. Results A total of 834 patients were enrolled, including 596 ERA and 238 non-RA. The sensitivity of ERA criteria (87.1%) was significantly higher than that of the 1987 ACR criteria (50.2%, P < 0.001) and similar to the 2010 ACR/EULAR criteria (89.4%, P > 0.05). The specificity of ERA criteria (92.0%) was similar to the 2010 ACR/EULAR (91.2%, P > 0.05) and 1987 ACR criteria (95.8%, P > 0.05). The AUC related to ERA (0.964) was slightly superior to that of 2010 ACR/EULAR (0.962, P > 0.05) and significantly higher than the 1987 ACR criteria (0.898, P < 0.001). The level of agreement between the 1987 ACR and 2010 ACR/EULAR criteria was 0.383; the 2010 ACR/EULAR and ERA criteria were 0.762, while the 1987 ACR and ERA criteria were 0.473. Conclusion The ERA and 2010 ACR/EULAR criteria were accordant. They identified more ERA patients than did the 1987 criteria. The ERA criteria are more feasible than the 2010 ACR/EULAR criteria.<Table Float="No" ID="Taba"> <tgroup cols="1"> <colspec align="left" colname="c1" colnum="1" /> <tbody> <row> <entry align="left" colname="c1"> Key Points </entry> </row> <row> <entry align="left" colname="c1"> • RA is prone to severe disability and premature mortality. Early diagnosis and intervention are crucial for RA patients. • The 2010 ACR/EULAR criteria only slightly improved the 1987 ACR criteria and are not sufficiently accurate in the early identification of autoantibody-negative RA. • The ERA and 2010 ACR/EULAR criteria were accordant. They identified more patients with ERA than did the 1987 criteria. • ERA criteria are more feasible than the 2010 ACR/EULAR criteria. </entry> </row> </tbody> </tgroup> </Table>

Comparison of agreement between three classification criteria for early rheumatoid arthritis (ERA) in Shanxi Province of China

期刊论文
发表日期：

2026年2月28日

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Yucui Li,
Ke Xu,
Guangying Liu,
Wei Li,
Ling Yao,
Weihua Chen,
Xiaoxu Wang,
Mei Feng,
Xiaofeng Li

摘要

Objective

To compare the agreement between three classification criteria for early rheumatoid arthritis (ERA) in Shanxi Province of China.

Methods

Patients whose age was more than 16 years old, disease duration no more than 2 years, and at least one joint swelling and tenderness were enrolled in a multicenter, retrospective cohort. The patients were grouped as RA or non-RA with detailed clinical and laboratory parameters recorded. The sensitivity and specificity of these criteria were compared with McNemar, and the areas under the ROC curves (AUC) were analyzed with MedCalc. The level of agreement between the three classification criteria was analyzed with kappa coefficient.

Results

A total of 834 patients were enrolled, including 596 ERA and 238 non-RA. The sensitivity of ERA criteria (87.1%) was significantly higher than that of the 1987 ACR criteria (50.2%, P < 0.001) and similar to the 2010 ACR/EULAR criteria (89.4%, P > 0.05). The specificity of ERA criteria (92.0%) was similar to the 2010 ACR/EULAR (91.2%, P > 0.05) and 1987 ACR criteria (95.8%, P > 0.05). The AUC related to ERA (0.964) was slightly superior to that of 2010 ACR/EULAR (0.962, P > 0.05) and significantly higher than the 1987 ACR criteria (0.898, P < 0.001). The level of agreement between the 1987 ACR and 2010 ACR/EULAR criteria was 0.383; the 2010 ACR/EULAR and ERA criteria were 0.762, while the 1987 ACR and ERA criteria were 0.473.

Conclusion

The ERA and 2010 ACR/EULAR criteria were accordant. They identified more ERA patients than did the 1987 criteria. The ERA criteria are more feasible than the 2010 ACR/EULAR criteria.

Key Points

• RA is prone to severe disability and premature mortality. Early diagnosis and intervention are crucial for RA patients.

• The 2010 ACR/EULAR criteria only slightly improved the 1987 ACR criteria and are not sufficiently accurate in the early identification of autoantibody-negative RA.

• The ERA and 2010 ACR/EULAR criteria were accordant. They identified more patients with ERA than did the 1987 criteria.

• ERA criteria are more feasible than the 2010 ACR/EULAR criteria.