Jacobsson L T, Knowler W C, Pillemer S, Hanson R L, Pettitt D J, McCance D R, Bennett P H
National Institute of Arthritis and Musculoskeletal and Skin Diseases, Phoenix, Arizona.
Arthritis Rheum. 1994 Oct;37(10):1479-86. doi: 10.1002/art.1780371011.
To compare the diagnostic properties of the Rome 1961 criteria for active rheumatoid arthritis (RA) and the American College of Rheumatology (ACR; formerly, the American Rheumatism Association) 1987 criteria for RA with regard to their ability to classify, diagnose, and predict outcome in RA.
Analysis of cross-sectional and longitudinal data from repeated health examinations and review of clinical records of 3,509 Pima Indians followed up from January 1966 to December 1990.
The ACR 1987 criteria identified approximately 50% of the cases identified by the Rome 1961 criteria, in both cross-sectional and longitudinal analyses. The ACR 1987 criteria were better predictors of subsequent development of a clinically supported diagnosis and treatment with slow-acting antirheumatic drugs (both P < 0.001), but were less sensitive than the Rome 1961 criteria for detecting cases for which there already was a clinically supported diagnosis (P < 0.001).
In a population-based analysis, the ACR 1987 criteria are less sensitive for detecting clinical disease, but predict a clinically more severe prognosis, compared with the Rome 1961 criteria. The sensitivity of both sets of criteria to identify clinical disease is improved if multiple examinations or inactive disease are taken into account.
比较1961年罗马标准对活动期类风湿关节炎（RA）的诊断特性以及美国风湿病学会（ACR；原美国风湿病协会）1987年RA标准在RA分类、诊断及预测结局方面的能力。
分析1966年1月至1990年12月对3509名皮马印第安人进行重复健康检查得到的横断面和纵向数据，并查阅其临床记录。
在横断面和纵向分析中，1987年ACR标准识别出的病例约为1961年罗马标准识别出病例的50%。1987年ACR标准对随后临床上支持的诊断及使用慢作用抗风湿药物治疗的预测性更好（均P<0.001），但在检测已有临床支持诊断的病例方面不如1961年罗马标准敏感（P<0.001）。
在基于人群的分析中，与1961年罗马标准相比，1987年ACR标准在检测临床疾病方面敏感性较低，但预测的临床预后更严重。如果考虑多次检查或非活动期疾病，两组标准识别临床疾病的敏感性均会提高。
