Rheumatoid factor isotypes in rheumatoid arthritis diagnosis and prognosis: a systematic review and meta-analysis
Authors' conclusion
Testing RF allows the highest sensitivity, while IgA isotype the highest specificity and positive likelihood ratio for RA diagnosis. On the other hand, determination of RF isotypes dose not allow prognostic information, as data are limited and heterogeneous.
Study context
- Population
- Patients in studies of rheumatoid factor (RF) isotypes in rheumatoid arthritis (RA) diagnosis and prognosis (PubMed, English, to 31 July 2022)36 articles
- Participants
- 7,517 patients
- Comparison
- RF isotypes for RA diagnosis and prognosis
- Outcome
- Role of RF isotypes in the diagnosis and prognosis of RA
Methodological detailstwo independent assessments of quality and biases
- Two independent assessments of quality and biases
Pooled result
As reported in the abstract
Diagnostic accuracy for RA
| Group | Sensitivity (highest) | Specificity (highest) | Positive likelihood ratio (highest) | Diagnostic OR (highest) |
|---|---|---|---|---|
| All RF isotypes | 68.6% (95% CI 66.2% to 71.0%) | |||
| IgA | 91.4% (95% CI 90.8% to 92.0%) | 7.7 (95% CI 5.7 to 10.4) | ||
| IgM | 21.7 (95% CI 16.1 to 29.3) |
Sensitivity (highest)
All RF isotypes68.6% (95% CI 66.2% to 71.0%)
IgA— not stated in the abstract
IgM— not stated in the abstract
Specificity (highest)
All RF isotypes— not stated in the abstract
IgA91.4% (95% CI 90.8% to 92.0%)
IgM— not stated in the abstract
Positive likelihood ratio (highest)
All RF isotypes— not stated in the abstract
IgA7.7 (95% CI 5.7 to 10.4)
IgM— not stated in the abstract
Diagnostic OR (highest)
All RF isotypes— not stated in the abstract
IgA— not stated in the abstract
IgM21.7 (95% CI 16.1 to 29.3)
Further pooled results
- RF isotypes do not provide relevant prognostic information; results conflicting
Original publication
Rheumatoid factor isotypes in rheumatoid arthritis diagnosis and prognosis: a systematic review and meta-analysis. RMD Open. Published 4 August 2023. doi:10.
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