{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T12:50:34Z","timestamp":1790859034761,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2016,6,23]],"date-time":"2016-06-23T00:00:00Z","timestamp":1466640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Center for Translational Molecular Medicine and by the Dutch Arthritis Foundation, project TRACER","award":["O41-202"],"award-info":[{"award-number":["O41-202"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>New opportunities have emerged for early diagnosis with the arrival of new technologies that assess the impact of genomics, proteomics, metabolomics, and cytomics on rheumatoid arthritis (RA) risk. This early health technology assessment study assesses the short\u2010term cost effectiveness of 4 add\u2010on diagnostic tests in early inflammatory arthritis patients at risk of RA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We modeled 4 diagnostic add\u2010on tests to the American College of Rheumatology\/European League Against Rheumatism 2010 RA classification criteria, covering the first year after diagnosis, using Rotterdam Early Arthritis Cohort data. Sensitivity, specificity, and costs were assigned to the magnetic resonance imaging of hands and feet (sensitivity 0.90, specificity 0.60, cost \u20ac756), interleukin\u20106 (IL\u20106) serum level test (sensitivity 0.70, specificity 0.53, cost \u20ac50), B cell\u2013related gene expression (sensitivity 0.60, specificity 0.90, cost \u20ac150), and gene assay for RA (sensitivity 0.40, specificity 0.85, cost \u20ac750), based on literature and expert opinion. Outcomes were evaluated using the unweighted diagnostic net benefit (UDNB) and the incremental cost\u2010effectiveness ratio (ICER) in all patients (n\u2009=\u2009552), intermediate\u2010risk patients (n\u2009=\u2009263), and seronegative patients (n\u2009=\u2009329).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The highest UDNB was found when using the B cell assay in intermediate\u2010risk patients (43%, ICER \u20ac5,314), while the IL\u20106 test in seronegative patients resulted in the lowest UDNB (\u221211.4%, ICER \u20ac7,650). If a threshold of \u20ac20,000 is applied, the B cell assay would be preferred over the other alternatives, with a 78% probability of being cost effective for intermediate\u2010risk patients, 57% for all patients, and 73% for seronegative patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Diagnostic add\u2010on tests favoring specificity over sensitivity with a headroom less than \u20ac370 per test are cost effective, with the largest diagnostic benefit occurring in intermediate\u2010risk patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.22776","type":"journal-article","created":{"date-parts":[[2015,11,10]],"date-time":"2015-11-10T13:54:46Z","timestamp":1447163686000},"page":"927-935","source":"Crossref","is-referenced-by-count":13,"title":["Cost\u2010Effectiveness Model for Evaluating New Diagnostic Tests in the Evaluation of Patients With Inflammatory Arthritis at Risk of Having Rheumatoid Arthritis"],"prefix":"10.1002","volume":"68","author":[{"given":"Jolanda J.","family":"Luime","sequence":"first","affiliation":[{"name":"Erasmus Medical Center and Erasmus University Rotterdam Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leander R.","family":"Buisman","sequence":"additional","affiliation":[{"name":"Erasmus Medical Center and Erasmus University Rotterdam Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Oppe","sequence":"additional","affiliation":[{"name":"Erasmus University Rotterdam, and EuroQol Research Foundation Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna M. W.","family":"Hazes","sequence":"additional","affiliation":[{"name":"Johanna M. W. Hazes, MD, PhD: Erasmus Medical Center, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen P. M. H.","family":"Rutten\u2010van M\u00f6lken","sequence":"additional","affiliation":[{"name":"Maureen P. M. H. Rutten\u2010van M\u00f6lken: Erasmus University Rotterdam, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,6,23]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ken205"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2011.78"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.61.10.911"},{"key":"e_1_2_6_5_1","first-page":"2460","article-title":"Total incidence and distribution of inflammatory joint diseases in a defined population: results from the Kuopio 2000 arthritis survey","volume":"30","author":"Savolainen E","year":"2003","journal-title":"J Rheumatol"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.22353"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2011-200038"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2011.154583"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2011-201063"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar4132"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-202696"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.27584"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.142299"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2011-200975"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.27294"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keu323"},{"key":"e_1_2_6_17_1","unstructured":"Dutch Healthcare Authority. 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