Centre for Rheumatology and Clinical Immunology, Division of Medicine, Turku University Hospital and University of Turku, Turku, Finland.
Centre for Rheumatic Diseases, Tampere University Hospital, Tampere, Finland.
Scand J Rheumatol. 2023 Jan;52(1):1-9. doi: 10.1080/03009742.2021.1967047. Epub 2021 Oct 13.
The aim of this study was to determine the validity of rheumatoid arthritis (RA) diagnoses in patients participating in Finnish biobanks.
We reviewed the electronic medical records of 500 Finnish biobank participants: 125 patients with at least one visit with a diagnosis of seropositive RA, 125 patients with at least one visit with a diagnosis of seronegative RA, and 250 age- and gender-matched controls. The patients were chosen from five different biobank hospitals in Finland. A rheumatologist reviewed the medical records to assess whether each patients' diagnosis was correct. The diagnosis was compared with the diagnostic codes in the Finnish Care Register for Health Care (CRHC) and special reimbursement data of the Social Insurance Institution of Finland.
The positive predictive value (PPV) of CRHC diagnosis of RA (for seropositive and seronegative RA combined) was 0.82. For patients with a special reimbursement for anti-rheumatic medications for RA, the PPV was 0.89. The PPV was higher in patients with more than one visit. For one, two, five, and 10 visits, the PPV was 0.82, 0.85, 0.89, and 0.90, respectively, and for patients who also had the special reimbursement, the PPV was 0.89, 0.91, 0.93, and 0.94 for one, two, five, and 10 visits, respectively. In patients positive for anti-citrullinated protein antibodies, the PPV was 0.98.
These results demonstrate that the validity of RA diagnoses in Finnish biobanks was good and can be further improved by including data on special reimbursement for medication, number of visits, and serological data.
本研究旨在确定参与芬兰生物库的患者的类风湿关节炎（RA）诊断的有效性。
我们回顾了 500 名芬兰生物库参与者的电子病历：125 名至少有一次血清阳性 RA 诊断就诊的患者，125 名至少有一次血清阴性 RA 诊断就诊的患者，以及 250 名年龄和性别匹配的对照者。这些患者是从芬兰的五家不同的生物库医院中选择的。一名风湿病专家审查了病历，以评估每位患者的诊断是否正确。该诊断与芬兰医疗保健注册中心（CRHC）的诊断代码和芬兰社会保险机构的特殊报销数据进行了比较。
CRHC 诊断 RA（包括血清阳性和血清阴性 RA）的阳性预测值（PPV）为 0.82。对于因 RA 而接受抗风湿药物特殊报销的患者，PPV 为 0.89。就诊次数越多，PPV 越高。就诊一次、两次、五次和十次的 PPV 分别为 0.82、0.85、0.89 和 0.90，对于同时接受特殊报销的患者，就诊一次、两次、五次和十次的 PPV 分别为 0.89、0.91、0.93 和 0.94。抗瓜氨酸蛋白抗体阳性的患者的 PPV 为 0.98。
这些结果表明，芬兰生物库中 RA 诊断的有效性良好，可以通过纳入药物特殊报销、就诊次数和血清学数据进一步提高。
