Table 4.6American Rheumatism Association (ARA) and New York (NY) criteria

StudyPatient groupUseClinical features
1 case-series17
Level 3
Arthritic symptoms who developed RAPredictors of developing RABest predictors: combinations of 8th ARA criteria (swelling in 1 joint and swelling or tenderness in another 4 joints) + (symmetrical swelling or tenderness in PIP or MCP or MTP joints) or (3 swollen and tender joints): Increase in specificities for predicting: RA with 5 erosive joints, 83% or 82%; RF+ and RF-RA both 93%; RF+ or erosive RA (both 100%)
Not predictors: NY and ARA criteria (except 8th ARA criterion – had highest Yuden Indexes* for predicting: RA with 5 erosive joints, 53; RF+ and RF-RA 69; RF+ or erosive RA 72; specificities 75%, 86% and 98%)
1 case-series18
Level Ib
Early IA who developed RADistinguish RA from other disorders (RA vs non-RA)Not distinguish: ACR criteria (not very sensitive – value not given)
1 case-series20
Level 3
Early IA who developed RAFeatures present at first visit/presentation47% had RA or fulfilled ACR criteria at follow-up
1 case-series21
Level II
Early IAIdentify patients with RA diagnosis (physician diagnosis)Low sensitivity and specificity: ARA criteria
List format: sensitivity 62%, specificity 50%
Tree format: sensitivity 78%, specificity 35%
1 case-series22
Level II
Recent inflammatory joint diseaseDetect RABest ARA or NY classification criteria (Yuden Index):
RF (73), symmetrical polyarthritis (especially the NY clinical criterion – 48), morning stiffness (43) and x-ray changes (38)

PIP = proximal interphalangeal joints; Yuden Index (sensitivity + specificity −100; maximum = 100)

From: 4, Referral, diagnosis and investigations

Cover of Rheumatoid Arthritis
Rheumatoid Arthritis: National Clinical Guideline for Management and Treatment in Adults.
NICE Clinical Guidelines, No. 79.
National Collaborating Centre for Chronic Conditions (UK).
Copyright © 2009, Royal College of Physicians of London.

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