Leiden_Clinical_Prediction_Rule_guideline v.1

Leiden Clinical Prediction Rule for Undifferentiated Arthritis

Maryam Razavi

maryam.razavi@cambio.se

CambioCDS

To diagnose rheumatoid arthritis.

Use in patients with recent-onset undifferentiated arthritis. Variables and points are as following: _ Age, years: Multiply by 0.02 - Sex: Male=0, Female=1 - Distribution of involved joints: Small joints in hands/feet=0.5, Upper extremities only=1, Upper and lower extremities=1.5, Other=0 - Symmetric distribution: No=0, Yes=0.5 - Duration of morning stiffness: <30 min=0, 30-59 min=0.5, ≥60 min=1 - Number of tender joints (out of 68): <4=0, 4-10=0.5, ≥11=1 - Number of swollen joints (out of 66): <4=0, 4-10=0.5, ≥11=1 - C-reactive protein level, mg/L: <5=0, 5-50=0.5, ≥51=1.5 - Rheumatoid factor: Negative=0, Positive=1 - Anti-CCP antibodies: Negative=0, Positive=2 Formula: Age x 0.02 + sum of all other selected points Interpretation: Score ≤6.0= Risk group Low Score >6.0 and <8.0= Risk group Indeterminate Score ≥8.0= Risk group High

1. Van der helm-van mil AH, Le cessie S, Van dongen H, Breedveld FC, Toes RE, Huizinga TW. A prediction rule for disease outcome in patients with recent-onset undifferentiated arthritis: how to guide individual treatment decisions. Arthritis Rheum. 2007;56(2):433-40. 2. Van der helm-van mil AH, Detert J, Le cessie S, et al. Validation of a prediction rule for disease outcome in patients with recent-onset undifferentiated arthritis: moving toward individualized treatment decision-making. Arthritis Rheum. 2008;58(8):2241-7. 3. Mcnally E, Keogh C, Galvin R, Fahey T. 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. Semin Arthritis Rheum. 2014;43(4):498-507.

OBSERVATION.basic_demographic_vitd.v1, OBSERVATION.leiden_clinical_prediction_rule.v0