Value of laboratory tests in early prediction of rheumatoid arthritis

Arthritis Rheum. 2002 Apr 15;47(2):155-65. doi: 10.1002/art.10241.


Objective: To determine which laboratory test or tests at presentation best predicted a diagnosis of rheumatoid arthritis (RA) 2 years later.

Methods: Two hundred seventy patients with early arthritis seen in 7 hospitals underwent comprehensive evaluations at 6-month intervals for 2 years, when the diagnosis of RA was assessed by 5 rheumatologists. The sensitivity and specificity of each test at the first visit for discriminating between RA (38%, n = 98) and non-RA patients were determined. Optimal cutoffs for continuous tests were derived from receiver operating characteristic curves. Sensitivity and specificity of test combinations selected by multiple logistic regression were determined.

Results: IgM rheumatoid factor (RF) by enzyme-linked immunosorbent assay, IgG-antikeratin antibody (AKA), and latex test had the strongest associations with RA. These 3 tests formed the most powerful combination for distinguishing RA from non-RA.

Conclusion: IgM-RF, IgG-AKA, and the latex test are the best laboratory tests for discriminating between patients with and without RA. Combining these tests slightly improves diagnostic value.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Arthritis, Rheumatoid / diagnosis*
  • Autoantibodies / blood
  • Clinical Laboratory Techniques*
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Follow-Up Studies
  • Humans
  • Immunoglobulin G / blood
  • Immunoglobulin M / blood
  • Keratins / immunology
  • Latex Fixation Tests
  • Male
  • Middle Aged
  • ROC Curve
  • Regression Analysis
  • Rheumatoid Factor / blood
  • Sensitivity and Specificity


  • Autoantibodies
  • Immunoglobulin G
  • Immunoglobulin M
  • Keratins
  • Rheumatoid Factor