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Rheumatoid Arthritis Likelihood Decision Tool
Dec 21, 2024
•
Mark Morgan
categories:
rheumatology
This is a rheumatology decision tool.
Rheumatoid Arthritis Likelihood Decision Tool
See also the 2010 American College of Rheumatology/European League Against Rheumatism Criteria calculator
Begin with patient with undifferentiated arthritis
Findings:
1. Age
18
19
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25
26
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100
(.02 points per year)
2. Gender
Female (1 point)
Male (0 points)
3. Distribution of joints (patient may have more than one item)
no (0 points)
yes (0.5 points)
< Small joints of the hands or feet
No other locations (0 points)
Other locations at upper extremities (1 point)
Other locations at upper and lower extremities (1.5 points)
<-- Other locations
no (0 points)
yes (0.5 points)
<-- Symmetrical
4. Score of morning stiffness on a 100-mm visual analog scale (0-100)
0 to 25 (0 points)
26 to 90 (1 point)
91 to 100 (2 points)
5. Number of tender joints
0 to 3 (0 points)
4 to 10 (0.5 points)
11 or more (1 point)
6. Number of swollen joints
0 to 3 (0 points)
4 to 10 (0.5 points)
11 or more (1 point)
7. C-reactive protein range
less than 50 mg per dL (0 points)
50 to 500 mg per dL (0.5 points)
greater than 500 mg per dL (1.5 points)
8. Rheumatoid Factor test
negative (0 points)
positive (1 point)
9. Anticyclic citrullinated peptide antibody test
negative (0 points)
positive (2 points)
Score -->
number
score1=(((age)*(.02))+(gender)+(dist1)+(dist2)+(dist3)+(tender)+(swollen)+(crp)+(rf)+(ccp)).toFixed(2)
points
Likelihood ratio and recommendation -->
interpretation
score2=((age)*(.02))+(gender)+(dist1)+(dist2)+(dist3)+(tender)+(swollen)+(crp)+(rf)+(ccp);score2>8.5?'likelihood ratio 12.7 - 85% of patients with these findings diagnosed with RA at the 1 year mark - refer to rheumatologist for evaluation and consideration of DMARD therapy':score2>6.5?'likelihood ratio 3.0 - 57% of patients with these findings diagnosed with RA at the 1 year mark - refer to rheumatologist for evaluation and consideration of DMARD therapy':score2>3.5?'likelihood ratio 0.42 - 16% of patients with these findings diagnosed with RA at the 1 year mark':'likelihood ratio 0 - 0% of patients with these findings diagnosed with RA at the 1 year mark'
display/hide references
reference:
#1
Am Fam Physician. 2008 May 15;77(10):1451-1453
#2
van der Helm-van Mil AH, le Cessie S, van Dongen H, Breedveld FC, Toes RE, Huizinga TW. A prediction rule for disease outcome in patients with recent-onset undifferentiated arthritis: how to guide individual treatment decisions. Arthritis Rheum. 2007;56(2):433–440.
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