ArticleAnnals of the rheumatic diseases2002
Clinical decision rules in rheumatoid arthritis: do they identify patients at high risk for osteoporosis? Testing clinical criteria in a population based cohort of patients with rheumatoid arthritis recruited from the Oslo Rheumatoid Arthritis Register.
Article in Annals of the rheumatic diseases, 2002. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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13 citing papers in PubMed, 1 synthesis or guideline pooled it, 46 citations in OpenAlex.
- Systematic review and meta-analysis of the performance of clinical risk assessment instruments for screening for osteoporosis or low bone density.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2015Pooled it
- A diagnostic model for assessing the risk of osteoporosis in patients with rheumatoid arthritis based on bone turnover markers.Arthritis research & therapy · 2025Article
- Article
- South Asian Working Action Group on SARCOpenia (SWAG-SARCO) - A consensus document.Osteoporosis and sarcopenia · 2022Review
- The Effect of Inflammation on Bone.Frontiers in physiology · 2020Review
- Male patients with rheumatoid arthritis have an increased risk of osteoporosis: Frequency and risk factors.Medicine · 2018Observational
- Osteoimmunology and osteoporosis.Arthritis research & therapy · 2011Review
- Combination therapy with dexamethasone and osteoprotegerin protects against arthritis-induced bone alterations in antigen-induced arthritis of the rat.Inflammation research : official journal of the European Histamine Research Society ... [et al.] · 2010Article
- Significance of risk factors for osteoporosis is dependent on gender and menopause in rheumatoid arthritis.Rheumatology international · 2008Article
- The utility of clinical decision tools for diagnosing osteoporosis in postmenopausal women with rheumatoid arthritis.BMC musculoskeletal disorders · 2008Article
- Association of bone mineral density and vertebral deformity in patients with rheumatoid arthritis.Rheumatology international · 2007Article
- Strategies for the prevention and treatment of osteoporosis in patients with rheumatoid arthritis.Drugs & aging · 2006Article
- Development and validation of the osteoporosis prescreening risk assessment (OPERA) tool to facilitate identification of women likely to have low bone density.Clinical rheumatology · 2005Article
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6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPreliminary clinical criteria based on age, inflammation, and immobility have been proposed to identify which patients with rheumatoid arthritis (RA) should be examined by dual energy x ray absorptiometry (DXA) to diagnose osteoporosis. The three item criteria have not been evaluated in male patients with RA or in the entire female RA population.
objectives(1) To test the proposed criteria in a cohort of men and women thought to be representative of the entire underlying RA population. (2) To develop clinical decision rules, which could be applied to all patients with RA irrespective of corticosteroid use.
methodsClinical and demographic data were collected from a total of 287 representative patients with RA (235 (82%) women, 52 (18%) men, age range 25.3-73.1 years) from the Oslo RA register (completeness 85%). Bone mineral density (BMD) was measured in spine L2-4 (anterior-posterior view) and femoral neck by DXA. The criteria were applied and sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated.
resultsMean age (SD) for the women and men with RA was 56.8 (11.0) years and 61.5 (10.2) years; disease duration was 15.5 (9.5) years and 14.7 (8.6) years. Of the women 163 (69%) were postmenopausal. One hundred and seventeen (50%) women and 28 (54%) men fulfilled the three item criteria. For the diagnosis of osteoporosis (T score <or=-2.5) using the original three item criteria sensitivity in women and men was 74% and 67%, specificity 57% and 50%, PPV 32% and 29% and NPV 89% and 83%, and including weight and ever use of corticosteroids in a five item criteria sensitivity increased to 82% and 83%, specificity decreased to 45% and 45%, PPV was 29% and 31%, and NPV was 90% and 90% respectively.
conclusionThe novel five item criteria (age, weight, inflammation, immobility, and ever use of corticosteroids) are a more accurate tool to identify patients with RA and osteoporosis than the original three item criteria (age, inflammation, and immobility). The clinical decision rules have an acceptable sensitivity and provide a practical tool for the doctor to identify patients with RA who should have a DXA measurement performed.
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