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Nishimura K, Sugiyama D, Kogata Y, et al. Meta-analysis: diagnostic accuracy of anti-cyclic citrullinated peptide antibody and rheumatoid factor for rheumatoid arthritis. Ann Intern Med 2007;146:797–808.
Clinical impact ratings Rheumatology ★★★★★★★ Internal medicine ★★★★★★⋆
Medline (to September 2006) and reference lists.
Study selection and assessment:
studies published after 1987 that evaluated the accuracy of RF or anti-CCP for diagnosis of RA in ⩾10 participants. 50 studies of RF (n = 15 286, median age 53 y, 68% women) and 37 studies of anti-CCP (n = 14 949, median age 57 y, 59% women) met the selection criteria.
pooled sensitivity, specificity, and positive and negative likelihood ratios (LRs). The reference standard for RA was the 1987 revised American College of Rheumatology criteria.
Anti-CCP and IgM RF had similar …
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