Accuracy of Diagnostic Codes and Algorithms Used to Identify Rheumatoid Arthritis and Juvenile Idiopathic Arthritis in Administrative Claims and Electronic Health Records: Systematic Review and Meta‐Analysis
Authors' conclusion
These findings support the use of more specific algorithms when diagnostic certainty is essential
Study context
- Population
- Studies validating case definitions for RA and JIA against a reference standard (e.g. rheumatologist-confirmed diagnosis or ACR/EULAR classification criteria)35 studies
- Comparison
- Algorithms using diagnostic codes in administrative claims and EHRs to identify RA and JIA, validated against a reference standard
- Outcome
- Diagnostic accuracy (sensitivity, specificity, PPV) of algorithms
Methodological detailsbivariate random-effects meta-analysis, narrative synthesis, screening, extraction and quality assessment in duplicate
- Bivariate random-effects meta-analysis
- Narrative synthesis
- Screening, extraction and quality assessment in duplicate
Pooled result
As reported in the abstract
Pooled diagnostic accuracy
| Strategy | Sensitivity | Specificity | PPV |
|---|---|---|---|
| International Classification of Diseases (ICD) + DMARD | 0.79 (95% CI 0.61-0.90) | 0.96 (95% CI 0.72-1.00) | 0.78 (95% CI 0.63-0.88) |
| Rheumatologist ICD code | 0.91 (95% CI 0.70-0.98) | 0.94 (95% CI 0.49-1.00) | 0.70 (95% CI 0.64-0.75) |
Sensitivity
International Classification of Diseases (ICD) + DMARD0.79 (95% CI 0.61-0.90)
Rheumatologist ICD code0.91 (95% CI 0.70-0.98)
Specificity
International Classification of Diseases (ICD) + DMARD0.96 (95% CI 0.72-1.00)
Rheumatologist ICD code0.94 (95% CI 0.49-1.00)
PPV
International Classification of Diseases (ICD) + DMARD0.78 (95% CI 0.63-0.88)
Rheumatologist ICD code0.70 (95% CI 0.64-0.75)
Original publication
Accuracy of Diagnostic Codes and Algorithms Used to Identify Rheumatoid Arthritis and Juvenile Idiopathic Arthritis in Administrative Claims and Electronic Health Records: Systematic Review and Meta‐Analysis. Arthritis Care Res (Hoboken). Published 20 January 2026. doi:10.
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