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Rheumatoid Arthritis Prediction Rule for Undifferentiated Arthritis

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1. Diagnostic accuracy of a clinical prediction rule (CPR) for identifying patients with recent-onset undifferentiated arthritis who are at a high risk of developing rheumatoid arthritis: a systematic review and meta-analysis

Diagnostic accuracy of a clinical prediction rule (CPR) for identifying patients with recent-onset undifferentiated arthritis who are at a high risk of developing rheumatoid arthritis: a systematic review and meta-analysis Diagnostic accuracy of a clinical prediction rule (CPR) for identifying patients with recent-onset undifferentiated arthritis who are at a high risk of developing rheumatoid arthritis: a systematic review and meta-analysis Diagnostic accuracy of a clinical prediction rule (...) (CPR) for identifying patients with recent-onset undifferentiated arthritis who are at a high risk of developing rheumatoid arthritis: a systematic review and meta-analysis McNally E, Keogh C, Galvin R, Fahey T CRD summary The authors concluded that a cut-off point of ≥9 or ≥10 on the Leiden clinical prediction rule may be optimal in identifying patients with undifferentiated arthritis at high risk of developing rheumatoid arthritis, but the results should be interpreted with caution. Limitations

2014 DARE.

2. Rheumatoid Arthritis Prediction Rule for Undifferentiated Arthritis

Rheumatoid Arthritis Prediction Rule for Undifferentiated Arthritis Rheumatoid Arthritis Prediction Rule for Undifferentiated Arthritis Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin (...) Exposure Miscellaneous Abuse Cancer Administration 4 Rheumatoid Arthritis Prediction Rule for Undifferentiated Arthritis Rheumatoid Arthritis Prediction Rule for Undifferentiated Arthritis Aka: Rheumatoid Arthritis Prediction Rule for Undifferentiated Arthritis II. Indications III. Criteria Points clc: Age (calculated points = AgeYrs * 0.02) Points 1.0: Female Gender Points 0.5: Small joints of hands or feet affected Points 0.5: Symmetric joints involved Points 1.0: Upper extremities affected Points

2018 FP Notebook

3. Diagnostic accuracy of a clinical prediction rule (CPR) for identifying patients with recent-onset undifferentiated arthritis who are at a high risk of developing rheumatoid arthritis: a systematic review and meta-analysis. (PubMed)

Diagnostic accuracy of a clinical prediction rule (CPR) for identifying patients with recent-onset undifferentiated arthritis who are at a high risk of developing rheumatoid arthritis: a systematic review and meta-analysis. The Leiden clinical prediction rule (CPR) was developed in 2007 to predict disease progression in patients with recent-onset undifferentiated arthritis (UA). This systematic review and meta-analysis investigates the predictive ability of the rule at identifying patients who (...) are at a high risk of developing rheumatoid arthritis (RA).A systematic review of the literature search was conducted from 2007 to May 2013 to identify studies that validated the rule. This study adhered to the PRISMA guidelines. The methodological quality of studies was assessed using the QUADAS-2 tool. Pooled sensitivity and specificity values for each of the cut points were generated using a bivariate random-effects model. Heterogeneity was assessed using the variance of logit-transformed sensitivity

2014 Seminars in arthritis and rheumatism

4. Validation of a Prediction Rule for the Diagnosis of Rheumatoid Arthritis in Patients with Recent Onset Undifferentiated Arthritis (PubMed)

Validation of a Prediction Rule for the Diagnosis of Rheumatoid Arthritis in Patients with Recent Onset Undifferentiated Arthritis Objectives. To validate van der Helm-van Mil score (vHvM) and new ACR/EULAR criteria for the diagnosis of rheumatoid arthritis (RA) in patients with undifferentiated arthritis (UA). Patients and Methods. Adult patients with UA (swelling ≥2 joints of less than 6 months duration, without diagnosis, and never treated with disease modifying drugs). Results. Ninety-one (...) sensitivity of 81% and 79.7% specificity. For the new ACR/EULAR criteria, the ROC AUC was 0.93, and a value equal to or greater than 6 showed 86.5% sensitivity and 87% specificity. Conclusion. van der Helm-van Mil prediction score and the new ACR/EULAR criteria proved to be valuable for the diagnosis of RA in patients with early UA.

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2013 International journal of rheumatology

5. Rheumatoid Arthritis Prediction Rule for Undifferentiated Arthritis

Rheumatoid Arthritis Prediction Rule for Undifferentiated Arthritis Rheumatoid Arthritis Prediction Rule for Undifferentiated Arthritis Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin (...) Exposure Miscellaneous Abuse Cancer Administration 4 Rheumatoid Arthritis Prediction Rule for Undifferentiated Arthritis Rheumatoid Arthritis Prediction Rule for Undifferentiated Arthritis Aka: Rheumatoid Arthritis Prediction Rule for Undifferentiated Arthritis II. Indications III. Criteria Points clc: Age (calculated points = AgeYrs * 0.02) Points 1.0: Female Gender Points 0.5: Small joints of hands or feet affected Points 0.5: Symmetric joints involved Points 1.0: Upper extremities affected Points

2015 FP Notebook

6. Validation of a prediction rule for development of rheumatoid arthritis in patients with early undifferentiated arthritis (PubMed)

Validation of a prediction rule for development of rheumatoid arthritis in patients with early undifferentiated arthritis To validate a model which predicts progression from undifferentiated arthritis (UA) to RA, in a Canadian UA cohort.The prediction rule, comprising variables which are scored from 0 to 13, with higher scores reflecting an increased risk of RA, was applied to baseline characteristics of all patients with UA. Progression to RA was determined at 6 months.105 patients were (...) identified. By 6 months, 80 (76%) had developed RA while 25 (24%) had developed another diagnosis. Number of tender and swollen joints, rheumatoid factor positivity, anti-cyclic citrullinated peptide positivity, poor functional status and high disease activity were associated with development of RA (p<0.01). Median prediction score was 8.0 for progressors, 5.0 for non-progressors. With these cut-off points, 18 (72%) patients with scores < or =5 did not develop RA, while 35 (97%) with scores > or =8 did

2009 EvidenceUpdates

7. A prediction rule for disease outcome in patients with undifferentiated arthritis using magnetic resonance imaging of the wrists and finger joints and serologic autoantibodies (PubMed)

A prediction rule for disease outcome in patients with undifferentiated arthritis using magnetic resonance imaging of the wrists and finger joints and serologic autoantibodies To evaluate whether magnetic resonance imaging (MRI) of the wrists and finger joints and an analysis of serologic autoantibodies are clinically meaningful for the subsequent development of rheumatoid arthritis (RA) in patients with undifferentiated arthritis (UA).A total of 129 patients with UA, a disease status formally (...) to have progressed to RA at 1 year, the PPV was increased to 100%. A close correlation was found between the present rule and that established in the Leiden Early Arthritis Cohort.MRI-proven early joint damage in conjunction with serologic autoantibodies is efficient in predicting progression from UA to RA. This method can be used to identify patients who would benefit from early treatment with disease-modifying antirheumatic drugs.

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2009 EvidenceUpdates

8. Clinical guidelines for the diagnosis and management of early rheumatoid arthritis

progressed further. 5 Clinical guideline for the diagnosis and management of early rheumatoid arthritis August 2009 In some studies, methotrexate (MTX) treatment has resulted in postponing the diagnosis of RA and retarding radiographic joint damage in undifferentiated inflammatory arthritis patients. 21 It is now well accepted that patients who are most likely to develop disabling arthritis should start DMARD therapy as soon as possible. 22 When patients start DMARD therapy early, they experience reduced (...) radiographic joint damage and greater maintenance of function compared with patients whose treatment is delayed. 21,23,24 The diagnosis and management of RA is a fast evolving field and it is important to keep up-to-date with the latest information. Articles such as Efficacy of MTX treatment in patients with probable RA 21 and What determines the evolution of early undifferentiated arthritis and rheumatoid arthritis? 22 are good sources of information. Principles of management of RA Successful treatment

2009 The Royal Australian College of General Practitioners

9. Ankylosing Spondylitis and Undifferentiated Spondyloarthropathy (Follow-up)

anti-TNF-alpha therapy, in addition to clinical examination and C-reactive protein (CRP) testing. [ ] Etanercept, [ , ] infliximab, [ , , ] adalimumab, [ ] golimumab, [ ] and certolizumab pegol [ , ] have all been approved by the US Food and Drug Administration (FDA) as therapies for AS and are indicated after NSAID therapy has failed. [ ] They are also approved for the treatment of rheumatoid arthritis and psoriatic arthritis (PsA). Other approved indications include the following: Psoriasis (...) receiving TNF-α antagonists. The most attention has been focused on lymphoma and nonmelanotic skin cancers in patients with rheumatoid arthritis, although this has been difficult to document in such patients and has not been described in patients with AS. In rare cases, cytopenias have been associated with TNF-α antagonists. Patients with rheumatoid arthritis who have recently started TNF-α antagonists may be at increased risk for new-onset congestive heart failure even in the absence of any obvious

2014 eMedicine.com

10. Ankylosing Spondylitis and Undifferentiated Spondyloarthropathy (Treatment)

anti-TNF-alpha therapy, in addition to clinical examination and C-reactive protein (CRP) testing. [ ] Etanercept, [ , ] infliximab, [ , , ] adalimumab, [ ] golimumab, [ ] and certolizumab pegol [ , ] have all been approved by the US Food and Drug Administration (FDA) as therapies for AS and are indicated after NSAID therapy has failed. [ ] They are also approved for the treatment of rheumatoid arthritis and psoriatic arthritis (PsA). Other approved indications include the following: Psoriasis (...) receiving TNF-α antagonists. The most attention has been focused on lymphoma and nonmelanotic skin cancers in patients with rheumatoid arthritis, although this has been difficult to document in such patients and has not been described in patients with AS. In rare cases, cytopenias have been associated with TNF-α antagonists. Patients with rheumatoid arthritis who have recently started TNF-α antagonists may be at increased risk for new-onset congestive heart failure even in the absence of any obvious

2014 eMedicine.com

11. Validation of a prediction rule for disease outcome in patients with recent-onset undifferentiated arthritis: Moving toward individualized treatment decision-making (PubMed)

Validation of a prediction rule for disease outcome in patients with recent-onset undifferentiated arthritis: Moving toward individualized treatment decision-making The decision to start disease-modifying antirheumatic drugs in patients with recent-onset undifferentiated arthritis (UA) is complicated by a varied natural disease course in which the disease in one-third of patients progresses to rheumatoid arthritis (RA), whereas 40-50% of patients experience spontaneous remission. Recently (...) , a prediction rule was developed to estimate the chance of progression to RA in individual patients presenting with UA. This study investigates the accuracy of this prediction rule in independent cohorts of patients with UA.In 3 cohorts of patients with recent-onset UA, from the UK, Germany, and The Netherlands, the prediction score and the corresponding chance of developing RA were calculated. These data were compared with the observed disease outcome after > or =1 year of followup. Positive predictive

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2008 EvidenceUpdates

12. Genetic variants in the prediction of rheumatoid arthritis. (PubMed)

Genetic variants in the prediction of rheumatoid arthritis. To determine whether the currently known genetic risk factors for rheumatoid arthritis (RA) improve the prediction of the development of RA compared to prediction using clinical risk factors alone in patients with undifferentiated arthritis (UA).Five hundred and seventy early UA-patients included in the Leiden Early Arthritis Clinic cohort, previously used to derive a clinical prediction rule, were used to explore the additional value (...) curve (AUC) was used as measure of the discriminative ability of the models.The AUC of a model consisting of genetic variants only was low, 0.536 (95% CI 0.48 to 0.59). The AUC of the model including genetic and clinical risk factors was not superior over the AUC of the clinical prediction rule (0.889, 95% CI 0.86 to 0.95 and 0.884, 95% CI 0.86 to 0.92).In a population at risk, information on currently known genetic risk factors for RA does not improve prediction of risk for RA compared

2010 Annals of the Rheumatic Diseases

13. Rheumatoid arthritis

not rule out RA, rather, the arthritis is called , which is in about 15-25% of people with RA. During the first year of illness, rheumatoid factor is more likely to be negative with some individuals becoming seropositive over time. RF is a non-specific antibody and seen in about 10% of healthy people, in many other chronic infections like , and chronic autoimmune diseases such as and . Therefore, the test is not for RA. Hence, new serological tests check for anti-citrullinated protein antibodies ACPAs (...) is in an undifferentiated stage (i.e. none of the above criteria is positive), even if synovitis is witnessed and assessed with ultrasound imaging. Monitoring progression [ ] Many tools can be used to monitor remission in rheumatoid arthritis. DAS28 Disease Activity Score of 28 joints ( DAS28 ) is widely used as an indicator of RA disease activity and response to treatment. Joints included are ( ): (10 joints), (10), (2), (2), (2) and (2). When looking at these joints, both the number of joints with tenderness upon

2012 Wikipedia

14. Spine imaging

Infectious and Inflammatory Conditions 12 Juvenile idiopathic arthritis (Pediatric only) 12 Multiple sclerosis or other white matter disease 12 Rheumatoid arthritis (Adult only) 12 Spinal infection 13 Spondyloarthropathy 13 Trauma 14 Cervical injury 14 Thoracic or lumbar injury 14 Tumor 15 Tumor 15 Miscellaneous Conditions of the Spine 15 Osteoporosis and osteopenia 15 Spinal cord infarction 16 Spondylolysis and spondylolisthesis 16 Syringomyelia 16 Signs and Symptoms 16 Cauda equina syndrome 16 (...) or effusion. 12 Laboratory assessment with appropriate tests can assist in increasing diagnostic certainty, excluding differential diagnoses, and predicting patients likely to progress to erosive disease. Base investigations usually include erythrocyte sedimentation rate or C-reactive protein and full blood count, with consideration given to rheumatoid factor, antinuclear antibody, and human leukocyte antigen B27. 12 When there is clinical diagnostic doubt, conventional radiographs (CR), ultrasound

2019 AIM Specialty Health

15. BSG consensus guidelines on the management of inflammatory bowel disease in adults

in the first two years is associated with a worse disease course subsequently.[7, 8] Statement 1. Where ulcerative colitis is diagnosed by sigmoidoscopy, we recommend a full ileocolonoscopy to delineate disease extent, severity of inflammation, and to exclude Crohn's disease (GRADE: strong recommendation, very low-quality evidence. Agreement: 100%) In patients presenting with suspected UC, stool cultures and Clostridium difficile toxin assay should always be performed to rule out infective causes. Whilst (...) UC is often initially diagnosed at flexible (or rigid) sigmoidoscopy, it is important to confirm the diagnosis, extent, and severity of disease by means of full ileocolonoscopy, usually within the first year, as this can more definitively confirm the diagnosis of UC versus Crohn’s disease, and give information that may help to predict future disease course, including potential and risk stratification for dysplasia,[9] and thus will influence treatment choices. For histological assessment at least

2019 British Society of Gastroenterology

16. Guideline for the management of adults with Systemic Lupus Erythematosus

Foundation Trust, Birmingham, Search for other works by this author on: Sue Brown Royal National Hospital for Rheumatic Diseases, Bath, Search for other works by this author on: Ian N. Bruce Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Institute for Inflammation and Repair, University of Manchester, Manchester Academic Health Sciences Centre,The Kellgren Centre for Rheumatology, NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University (...) cannot accurately predict renal biopsy findings. 2. Pathological assessment of kidney biopsy 98 The use of the International Society of Nephrology/Renal Pathology Society (ISN/RPS) 2003 classification system is recommended, with assessment not only of active and chronic glomerular and tubulointerstitial changes, but also of vascular lesions associated with aPLs/APS. Treatment of renal involvement 3. Indications and goals of immunosuppressive treatment in LN 98 3.1 Initiation of immunosuppressive

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2017 British Society for Rheumatology

17. Guideline on the management of premature ovarian insufficiency

is performed. GPP Autosomal genetic testing is not at present indicated in women with POI, unless there is evidence suggesting a specific mutation (e.g. BPES). GPP Screening for 21OH-Ab (or alternatively adrenocortical antibodies (ACA)) should be considered in women with POI of unknown cause or if an immune disorder is suspected. Refer POI patients with a positive 21OH-Ab/ACA test to an endocrinologist for testing of adrenal function and to rule out Addison’s disease. C Screening for thyroid (TPO-Ab (...) counselling and testing. B Relatives of women with non-iatrogenic premature ovarian insufficiency who are concerned about their risk for developing POI should be informed that: ? currently there is no proven predictive test to identify women that will develop POI, unless a mutation known to be related to POI was detected ? there are no established POI preventing measures ? fertility preservation appears as a promising option, although studies are lacking, and ? their potential risk of earlier menopause

2015 European Society of Human Reproduction and Embryology

18. Clinical practice guideline on Systemic Lupus Erythematosus

confirmation 68 4.2.1. Laboratory tests 68 4.2.2. Diagnostic and classification criteria 87 4.2.3. Initial evaluation tests after diagnosis 92 5. General management of systemic lupus erythematosus 107 5.1. Monitoring 107 5.1.1. Clinical monitoring protocol and complementary tests 107 5.1.2. Disease assessment tools 112 5.1.3. Predictive factors of flare or increase in disease activity 115 5.2. General therapeutic approach 118 5.2.1. Therapeutic objectives 118 5.2.2. Treatment indications 120 5.2.3. Adverse (...) . Lupus arthritis 222 6.4.1. Evaluation tools 222 6.4.2. Treatment 223 6.5. Mucocutaneous manifestations 227 6.5.1. Cutaneous lupus evaluation tools 227 6.5.2. Topical treatment 231 6.6. Antiphospholipid syndrome 233 6.6.1. Antiphospholipid antibodies 233 6.6.2. Prevention and treatment of thrombotic complications 235 7. Sexual and reproductive health 239 7.1. Pregnancy 239 7.1.1. Planning pregnancy 239 7.1.2. Monitoring pregnancy 241 7.1.3. Treatment with antimalarial drugs 244 7.1.4. Prevention

2015 GuiaSalud

19. Acute Pain Management: Scientific Evidence

perception 1 1.1.3 Physiological and pathological pain 7 1.2 Psychological aspects of acute pain 8 1.2.1 Psychological factors 9 1.2.2 Patient-controlled analgesia .. 11 1.3 Placebo and nocebo effects in acute pain 12 1.3.1 Mechanisms 13 1.4 Progression of acute to chronic pain 16 1.4.1 Epidemiology of chronic postsurgical pain 16 1.4.2 Characteristics of chronic postsurgical pain 17 1.4.3 Predictive factors for chronic postsurgical pain 18 1.4.4 Mechanisms for the progression from acute to chronic pain

2015 Clinical Practice Guidelines Portal

20. Diagnosis and Treatment Interstitial Cystitis/Bladder Pain Syndrome

is as severe as that of rheumatoid arthritis and end- stage renal disease. 9, 38 Health-related QoL in women with IC/BPS is worse than that of women with endometriosis, vulvodynia or overactive bladder. 39 Given that IC/BPS causes considerable morbidity over the course of a patient’s life and loss of work during the most productive years of work and family life significant negative psychological and QoL impacts are not surprising. 9 Sexual dysfunction has an especially important impact on the QoL of IC/BPS (...) as Clinical Principles and Expert Opinion when insufficient evidence existed. See text and algorithm for definitions and detailed diagnostic, management, and treatment frameworks. Guideline Statements Diagnosis: 1. The basic assessment should include a careful history, physical examination, and laboratory examination to rule in symptoms that characterize IC/BPS and rule out other confusable disorders (see text for details). Clinical Principle 2. Baseline voiding symptoms and pain levels should be obtained

2014 American Urological Association

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