Core Concepts
Efficient RA diagnosis through targeted testing.
Abstract
The content delves into the challenges of diagnosing rheumatoid arthritis (RA) efficiently and accurately. It highlights the critical role of clinical laboratories in identifying hidden cases of RA through strategic testing protocols. Key insights include:
Maria Salinas, PhD, emphasizes the importance of early identification of chronic conditions.
RA diagnosis is complex due to the absence of a single definitive lab test.
Amy Kehl, MD, recommends specific markers for inflammatory arthritis diagnosis.
Guidelines from the American College of Rheumatology outline criteria for diagnosing RA.
Overordering of autoimmune antibody tests leads to unnecessary referrals and increased costs.
Salinas's lab implemented a reflex testing algorithm to improve RA diagnosis rates.
The study showed a reduction in unnecessary RF tests and referrals post-implementation.
The COVID-19 pandemic impacted patient visits and lab test orders in Alicante.
Clinical decision support systems could enhance RA diagnosis practices in the US.
Stats
The RF test detects 60%-80% of patients with RA but is positive in other autoimmune conditions.
The anti-CCP antibody test detects 50%-70% of RA patients with 95% specificity.
The study period from April 2019 to January 2021 showed reduced RF tests and unnecessary referrals.
Quotes
"Classically, I find that the primary care physicians include a rheumatoid factor, not always a CCP, and may include other antibodies, including an ANA test, as part of that workup." - Amy Kehl, MD