The University of Southampton
University of Southampton Institutional Repository
Warning ePrints Soton is experiencing an issue with some file downloads not being available. We are working hard to fix this. Please bear with us.

Uso del factor reumatoide en atención primaria en España: estudio de cohortes poblacionales incluyendo 4,8 millones de participantes y casi medio millón de mediciones

Uso del factor reumatoide en atención primaria en España: estudio de cohortes poblacionales incluyendo 4,8 millones de participantes y casi medio millón de mediciones
Uso del factor reumatoide en atención primaria en España: estudio de cohortes poblacionales incluyendo 4,8 millones de participantes y casi medio millón de mediciones

Objective: Rheumatoid factor (RF) testing is used in primary care in the diagnosis of rheumatoid arthritis (RA); however a positive RF may occur without RA. Incorrect use of RF testing may lead to increased costs and delayed diagnoses. The aim was to assess the performance of RF as a test for RA and to estimate the costs associated with its use in a primary care setting. Material and methods: A retrospective cohort study using the Information System for the Development of Research in Primary Care database (contains primary care records and laboratory results of >80% of the Catalonian population, Spain). Participants were patients ≥18 years with ≥1 RF test performed between 01/01/2006 and 31/12/2011, without a pre-existing diagnosis of RA. Outcome measures were an incident diagnosis of RA within 1 year of testing, and the cost of testing per case of RA. Results: 495,434/4,796,498 (10.3%) patients were tested at least once. 107,362 (21.7%) of those tested were sero-positive of which 2768 (2.6%) were diagnosed with RA within 1 year as were 1141/388,072 (0.3%) sero-negative participants. The sensitivity of RF was 70.8% (95% CI 69.4–72.2), specificity 78.7% (78.6–78.8), and positive and negative predictive values 2.6% (2.5–2.7) and 99.7% (99.6–99.7) respectively. Approximately €3,963,472 was spent, with a cost of €1432 per true positive case. Conclusions: Although 10% of patients were tested for RF, most did not have RA. Limiting testing to patients with a higher pre-test probability would significantly reduce the cost of testing.

Electronic health records, Primary care, Rheumatoid arthritis, Rheumatoid factor, Sensitivity specificity
1699-258X
Morsley, Klara
612a6615-1142-44a0-9f25-e9c4a152d6fd
Miller, Anne
77097418-cafa-4338-8803-c7d66348b2da
Luqmani, Raashid
be06af41-8e76-4285-ab22-2b127992f153
Fina-Aviles, Francesc
f84327d3-dcad-4184-8152-1c32b1defb6e
Javaid, Muhammad Kassim
68b6dcd1-dacf-4891-96ee-c64e9c3d6f90
Edwards, Christopher J.
dcb27fec-75ea-4575-a844-3588bcf14106
Pinedo-Villanueva, Rafael
7375e99b-3bac-4210-841e-ec4724df9131
Medina, Manuel
525340d2-2c50-48fb-b19e-0bd8ed5de699
Calero, Sebastian
7218286b-cb90-48d1-8468-982b274b1d14
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Arden, Nigel
23af958d-835c-4d79-be54-4bbe4c68077f
Prieto-Alhambra, Daniel
e596722a-2f01-4201-bd9d-be3e180e76a9
Morsley, Klara
612a6615-1142-44a0-9f25-e9c4a152d6fd
Miller, Anne
77097418-cafa-4338-8803-c7d66348b2da
Luqmani, Raashid
be06af41-8e76-4285-ab22-2b127992f153
Fina-Aviles, Francesc
f84327d3-dcad-4184-8152-1c32b1defb6e
Javaid, Muhammad Kassim
68b6dcd1-dacf-4891-96ee-c64e9c3d6f90
Edwards, Christopher J.
dcb27fec-75ea-4575-a844-3588bcf14106
Pinedo-Villanueva, Rafael
7375e99b-3bac-4210-841e-ec4724df9131
Medina, Manuel
525340d2-2c50-48fb-b19e-0bd8ed5de699
Calero, Sebastian
7218286b-cb90-48d1-8468-982b274b1d14
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Arden, Nigel
23af958d-835c-4d79-be54-4bbe4c68077f
Prieto-Alhambra, Daniel
e596722a-2f01-4201-bd9d-be3e180e76a9

Morsley, Klara, Miller, Anne, Luqmani, Raashid, Fina-Aviles, Francesc, Javaid, Muhammad Kassim, Edwards, Christopher J., Pinedo-Villanueva, Rafael, Medina, Manuel, Calero, Sebastian, Cooper, Cyrus, Arden, Nigel and Prieto-Alhambra, Daniel (2018) Uso del factor reumatoide en atención primaria en España: estudio de cohortes poblacionales incluyendo 4,8 millones de participantes y casi medio millón de mediciones. Reumatologia Clinica. (doi:10.1016/j.reuma.2017.11.001).

Record type: Article

Abstract

Objective: Rheumatoid factor (RF) testing is used in primary care in the diagnosis of rheumatoid arthritis (RA); however a positive RF may occur without RA. Incorrect use of RF testing may lead to increased costs and delayed diagnoses. The aim was to assess the performance of RF as a test for RA and to estimate the costs associated with its use in a primary care setting. Material and methods: A retrospective cohort study using the Information System for the Development of Research in Primary Care database (contains primary care records and laboratory results of >80% of the Catalonian population, Spain). Participants were patients ≥18 years with ≥1 RF test performed between 01/01/2006 and 31/12/2011, without a pre-existing diagnosis of RA. Outcome measures were an incident diagnosis of RA within 1 year of testing, and the cost of testing per case of RA. Results: 495,434/4,796,498 (10.3%) patients were tested at least once. 107,362 (21.7%) of those tested were sero-positive of which 2768 (2.6%) were diagnosed with RA within 1 year as were 1141/388,072 (0.3%) sero-negative participants. The sensitivity of RF was 70.8% (95% CI 69.4–72.2), specificity 78.7% (78.6–78.8), and positive and negative predictive values 2.6% (2.5–2.7) and 99.7% (99.6–99.7) respectively. Approximately €3,963,472 was spent, with a cost of €1432 per true positive case. Conclusions: Although 10% of patients were tested for RF, most did not have RA. Limiting testing to patients with a higher pre-test probability would significantly reduce the cost of testing.

This record has no associated files available for download.

More information

Accepted/In Press date: 16 November 2017
e-pub ahead of print date: 26 February 2018
Alternative titles: Rheumatoid factor testing in Spanish primary care: A population-based cohort study including 4.8 million subjects and almost half a million measurements
Keywords: Electronic health records, Primary care, Rheumatoid arthritis, Rheumatoid factor, Sensitivity specificity

Identifiers

Local EPrints ID: 421220
URI: http://eprints.soton.ac.uk/id/eprint/421220
ISSN: 1699-258X
PURE UUID: 64faf4ce-8f42-4dcb-814d-d809f84d0d3d
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709

Catalogue record

Date deposited: 24 May 2018 16:31
Last modified: 26 Nov 2021 02:39

Export record

Altmetrics

Contributors

Author: Klara Morsley
Author: Anne Miller
Author: Raashid Luqmani
Author: Francesc Fina-Aviles
Author: Muhammad Kassim Javaid
Author: Rafael Pinedo-Villanueva
Author: Manuel Medina
Author: Sebastian Calero
Author: Cyrus Cooper ORCID iD
Author: Nigel Arden
Author: Daniel Prieto-Alhambra

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×