Diagnostic Accuracy of Raman Spectroscopy Integrated With Polarized Light Microscopy for Calcium Pyrophosphate–Associated Arthritis
Authors' conclusion
iRPolM can easily identify CPP crystals with a strong diagnostic performance.
Study context
- Population
- Consecutive synovial fluid samples, single hospital in the Netherlands
- Participants
- 400 synovial fluid samples
- Comparison
- Integrated Raman polarized light microscopy (iRPolM) vs reference standards polarized light microscopy (PLM) and 2023 American College of Rheumatology (ACR)/EULAR CPPD criteria
- Outcome
- Diagnostic accuracy of iRPolM for CPPD against PLM and the 2023 ACR/EULAR criteria
Methodological detailsconsecutive samples, single-centre
- Consecutive samples
- Single-centre
Performance
As reported in the abstract
Diagnostic performance of iRPolM vs 2023 ACR/EULAR criteria
| Test or model | κ (interrater reliability) | Sensitivity | Specificity | Positive likelihood ratio | Negative likelihood ratio | PPV | NPV | Accuracy |
|---|---|---|---|---|---|---|---|---|
| iRPolM | 0.88 | 86.0% (95% CI 73.3-94.2) | 99.1% (95% CI 97.5-99.8) | 100.33 (95% CI 32.3-311.3) | 0.14 (95% CI 0.07-0.28) | 93.5% (95% CI 82.2-97.8) | 98.0% (95% CI 82.2-97.8) | 97.5% (95% CI 95.5-98.8) |
iRPolM
κ (interrater reliability)0.88
Sensitivity86.0% (95% CI 73.3-94.2)
Specificity99.1% (95% CI 97.5-99.8)
Positive likelihood ratio100.33 (95% CI 32.3-311.3)
Negative likelihood ratio0.14 (95% CI 0.07-0.28)
PPV93.5% (95% CI 82.2-97.8)
NPV98.0% (95% CI 82.2-97.8)
Accuracy97.5% (95% CI 95.5-98.8)
Further findings
Agreement of iRPolM with rheumatologists' microscopic CPP identification by certainty
- κ between iRPolM and certain identification
- 0.87
- Uncertain CPP identifications confirmed with iRPolM
- 10%
Novel particle types in synovial fluid
- Calcium carbonate crystals, deposited carotenoids, microplastics, and three types of Maltese cross birefringent objects identified
Original publication
Diagnostic Accuracy of Raman Spectroscopy Integrated With Polarized Light Microscopy for Calcium Pyrophosphate–Associated Arthritis. Arthritis Care Res (Hoboken). Published 7 May 2024. doi:10.
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