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The Role of the Laboratory in the Diagnosis of Rheumatoid Arthritis



Sensitivity and Specificity Comparison Anti-CCP and RF

Slide 14

August 2011

In a study performed in our laboratory at the Mayo Clinic, we compared the sensitivity and specificity of the second and third generation anti-CCP antibody assays with our nephelometric assay for rheumatoid factor. We looked at a population of healthy individuals, as well as patients with rheumatoid arthritis and patients with other systemic rheumatic diseases. The first item to point out is that the overall sensitivity of both anti-CCP antibody assays is comparable to rheumatoid factor, all of which are approximately 80%. However, a small number of patients were positive for anti-CCP and negative for rheumatoid factor, and vice versa, so using both laboratory tests may offer a small increase in sensitivity. The second item to mention is that the specificity of the anti-CCP assays is improved over rheumatoid factor in both the healthy individuals and in patients with other connective tissue diseases. Using healthy individuals, the specificity of both anti-CCP antibody assays approaches close to 100%. However, this specificity appears to decrease slightly when evaluating patients with other connective tissue diseases. This may be due to the presence of overlap syndromes in some of these patients, although further studies are needed to clarify this.

Sensitivity and Specificity Comparison

 


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