Prodromal symptoms of rheumatoid arthritis in a primary care database: variation by ethnicity and socioeconomic status
Authors' conclusion
There are significant differences in coded symptoms between demographic groups, which must be considered in clinical practice in diverse populations and to avoid algorithmic bias in prediction tools derived from routinely collected healthcare data.
Study context
- Population
- Adults with a code for RA diagnosis in CPRD Aurum (English primary care), 1 January 2004 to 1 May 202266.4% female
- Participants
- 70,115 adults
- Exposure
- South Asian, Black ethnicity vs White; low vs highest socioeconomic quintile
- Outcome
- Coding of common symptoms (≥0.1% in the sample) preceding RA diagnosis
- Follow-up
- 24 months preceding RA diagnosis
Methodological detailsprimary care database (CPRD Aurum), logistic regression adjusted for sex, age, BMI and smoking status
- Primary care database (CPRD Aurum)
- Logistic regression adjusted for sex, age, BMI and smoking status
Main finding
As reported in the abstract
Odds ratio (99.76 % CI)
South Asianvs Whitemuscle cramps
1.71(1.44–2.57)
South Asianvs Whiteshoulder pain
1.44(1.25–1.66)
Blackvs Whiteunintended weight loss
2.02(1.25–3.28)
Blackvs Whiteankle pain
1.51(1.02–2.23)
Low socioeconomic statusvs Highest socioeconomic quintilemorning stiffness
1.74(1.08–2.80)
- Low socioeconomic status vs Highest socioeconomic quintile · falls; CI as printed
- OR 1.37 (99.76 % CI 2.03–1.82)
- Twenty-one symptoms coded in >0.1% of cases included in the analysis
- 21
Observational data: associations, not effects.
Original publication
Prodromal symptoms of rheumatoid arthritis in a primary care database: variation by ethnicity and socioeconomic status. Rheumatology (Oxford). Published 11 March 2024. doi:10.
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