{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T08:32:07Z","timestamp":1769157127634,"version":"3.49.0"},"reference-count":21,"publisher":"The Journal of Rheumatology","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"published-print":{"date-parts":[[2015,5]]},"abstract":"<jats:sec><jats:title>Objective.<\/jats:title><jats:p>Anticitrullinated protein antibodies (ACPA) are a highly specific and sensitive biomarker for the diagnosis of rheumatoid arthritis (RA). Some patients who were found to have a positive ACPA test were referred to our Rheumatology Central Triage (CT; Calgary, Alberta, Canada) for assessment by a rheumatologist. The objectives of our study were to determine the clinical accuracy of ACPA in establishing a diagnosis of RA in a real-time clinical setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods.<\/jats:title><jats:p>Cases that met 3 criteria were included in the study: (1) referred to the CT over 3 calendar years (n = 20,389), (2) reason for referral was a positive ACPA test (n = 568), and (3) evaluated by a certified rheumatologist (n = 314). An administrative serological database was used to retrieve specific ACPA results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>Of patients referred through our CT for evaluation of a positive ACPA test, 57.6% received a diagnosis of RA; the remainder had a variety of other diagnoses, some of which might be considered early RA (9%). The predictive values of ACPA for the diagnosis of RA were increased when rheumatoid factor (RF) results were included in the analysis. When definite and possible RA were combined and the prevalence of moderate\/high ACPA was compared to all other individuals, the positive and negative predictive values for moderate\/high ACPA for RA were 74.3% and 68.4%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion.<\/jats:title><jats:p>About 58% of patients with a positive ACPA referred through a triage system for a rheumatologist opinion received a diagnosis of RA at their first visit. RF provides additional useful information to guide the diagnosis and urgency of referral.<\/jats:p><\/jats:sec>","DOI":"10.3899\/jrheum.141054","type":"journal-article","created":{"date-parts":[[2015,2,2]],"date-time":"2015-02-02T01:13:25Z","timestamp":1422839605000},"page":"771-777","source":"Crossref","is-referenced-by-count":6,"title":["Clinical and Serological Analysis of Patients with Positive Anticyclic Citrullinated Peptide Antibodies Referred Through a Rheumatology Central Triage System"],"prefix":"10.3899","volume":"42","author":[{"given":"Liam","family":"Martin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Whitney A.","family":"Steber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terri L.","family":"Lupton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Mahler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christie M.","family":"Fitch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob D.","family":"McMillan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle R.","family":"Schmidt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marvin J.","family":"Fritzler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2262","published-online":{"date-parts":[[2015,2,1]]},"reference":[{"key":"2018112909341384000_42.5.771.1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI1316"},{"key":"2018112909341384000_42.5.771.2","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200001)43:1<155::AID-ANR20>3.0.CO;2-3"},{"key":"2018112909341384000_42.5.771.3","doi-asserted-by":"publisher","DOI":"10.1002\/art.27584"},{"key":"2018112909341384000_42.5.771.4","doi-asserted-by":"publisher","DOI":"10.1002\/art.27580"},{"key":"2018112909341384000_42.5.771.5","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2011.76"},{"key":"2018112909341384000_42.5.771.6","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2011.204"},{"key":"2018112909341384000_42.5.771.7","doi-asserted-by":"publisher","DOI":"10.1002\/art.11223"},{"key":"2018112909341384000_42.5.771.8","doi-asserted-by":"crossref","unstructured":"Rakieh C Nam JL Hunt L Hensor EM Das S Bissell LA Predicting the development of clinical arthritis in anti-CCP positive individuals with non-specific musculoskeletal symptoms: a prospective observational cohort study. Ann Rheum Dis 2014 Apr 12 (E-pub ahead of print).","DOI":"10.1136\/annrheumdis-2014-205227"},{"key":"2018112909341384000_42.5.771.9","doi-asserted-by":"crossref","unstructured":"Maehlen MT Olsen IC Andreassen BK Viken MK Jiang X Alfredsson L Genetic risk scores and number of autoantibodies in patients with rheumatoid arthritis. Ann Rheum Dis 2013 Dec 13 (E-pub ahead of print).","DOI":"10.1136\/annrheumdis-2013-204173"},{"key":"2018112909341384000_42.5.771.10","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0093812"},{"key":"2018112909341384000_42.5.771.11","doi-asserted-by":"publisher","DOI":"10.1007\/s12016-007-8029-y"},{"key":"2018112909341384000_42.5.771.12","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0b013e32832a2e44"},{"key":"2018112909341384000_42.5.771.13","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2007.085597"},{"key":"2018112909341384000_42.5.771.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2012.09.015"},{"key":"2018112909341384000_42.5.771.15","first-page":"387","article-title":"Detection of anti-nucleosome antibodies in a routine clinical laboratory setting","volume":"26","author":"Bossuyt","year":"2008","journal-title":"Clin Exp Rheumatol"},{"key":"2018112909341384000_42.5.771.16","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1398.016"},{"key":"2018112909341384000_42.5.771.17","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-012-2141-y"},{"key":"2018112909341384000_42.5.771.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2011.06.006"},{"key":"2018112909341384000_42.5.771.19","doi-asserted-by":"publisher","DOI":"10.1002\/art.20096"},{"key":"2018112909341384000_42.5.771.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2012.05.007"},{"key":"2018112909341384000_42.5.771.21","doi-asserted-by":"publisher","DOI":"10.1002\/art.30126"}],"container-title":["The Journal of Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.3899\/jrheum.141054","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,28]],"date-time":"2022-04-28T03:32:40Z","timestamp":1651116760000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.jrheum.org\/lookup\/doi\/10.3899\/jrheum.141054"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,2,1]]},"references-count":21,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2015,5,1]]},"published-print":{"date-parts":[[2015,5]]}},"alternative-id":["10.3899\/jrheum.141054"],"URL":"https:\/\/doi.org\/10.3899\/jrheum.141054","relation":{},"ISSN":["0315-162X","1499-2752"],"issn-type":[{"value":"0315-162X","type":"print"},{"value":"1499-2752","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,2,1]]}}}