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Table 3 The diagnostic value of morning stiffness (duration and severity) in early arthritis for classifying RA

From: Reappraisal of the diagnostic and prognostic value of morning stiffness in arthralgia and early arthritis: results from the Groningen EARC, Leiden EARC, ESPOIR, Leiden EAC and REACH

  OR (95% CI) adjusted for age and gender OR (95% CI) adjusted for age, gender, SJC, ACPA, RF ESR and symptom duration Sensitivity Specificity PPV NPV
Leiden EAC       
≥30 minutes 3.37 (2.83-4.03) 2.22 (1.66-2.96) 77.0% 51.5% 53.5% 75.5%
≥60 minutes 2.92 (2.47-3.44) 1.72 (1.31-2.25) 61.2% 66.1% 56.7% 70.1%
≥90 minutes 2.44 (2.04-2.92) 1.61 (1.19-2.18) 39.1% 80.3% 59.0% 64.5%
VAS 34-67 mm 1.87 (1.48-2.36) 2.10 (1.43-3.09) 56.5% 60.0% 49.1% 66.8%
VAS ≥68 mm 2.38 (1.89-3.00) 1.93 (1.32-2.83) 60.7% 61.8% 55.3% 66.8%
ESPOIR       
≥30 minutes 2.64 (1.81-3.87) 1.76 (1.07-2.88) 74.2% 47.8% 87.6% 27.1%
≥60 minutes 2.33 (1.59-3.44) 1.68 (1.03-2.74) 55.4% 64.7% 88.7% 22.6%
≥90 minutes 2.02 (1.28-3.20) 1.64 (0.92-2.92) 32.5% 80.9% 89.4% 19.4%
VAS 34-67 mm 2.04 (1.32-3.17) 1.93 (1.10-3.37) 61.0% 56.3% 85.7% 25.1%
VAS 68–100 mm 2.46 (1.53-3.96) 1.65 (0.88-3.11) 57.3% 63.7% 87.6% 25.1%
  1. RA is classified according to the 2010 ACR-EULAR criteria. VAS: (0 to 100 mm). In the analyses of VAS morning stiffness three categories were formed, the reference group was a VAS 0 to 33 mm. The sensitivity, specificity, PPV and NPV of the VAS morning stiffness were calculated against this reference group. RA, rheumatoid arthritis; OR, odds ratio; CI, confidence interval; SJC, swollen joint count; ACPA, anti-citrullinated protein antibody; RF, rheumatoid factor; ESR, erythrocyte sedimentation rate; PPV, positive predictive value; NPV, negative predictive value; EAC, Early Arthritis Clinic; VAS, visual analogue scale; ESPOIR, Evaluation et Suivi de POlyarthrites Indifférenciées Récentes; ACR, American College of Rheumatology; EULAR, European League Against Rheumatism.
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