Evidence map›Paper›PMID 38466930›Full record

ArticleRheumatology (Oxford, England)2025

Prodromal symptoms of rheumatoid arthritis in a primary care database: variation by ethnicity and socioeconomic status.

Alexander d'Elia, Aliaksandra Baranskaya, Shamil Haroon, Ben Hammond, Nicola J Adderley, Krishnarajah Nirantharakumar, Joht Singh Chandan, Marie Falahee, Karim Raza

Abstract read
In one paragraph

Article in Rheumatology (Oxford, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Alexander d'EliaDepartment of Public Health Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool, UK.ORCID 0000-0001-8735-9689
Aliaksandra BaranskayaRheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.
Shamil HaroonInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Ben HammondInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Nicola J AdderleyInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.ORCID 0000-0003-0543-3254
Krishnarajah NirantharakumarInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Joht Singh ChandanInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Marie FalaheeRheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.ORCID 0000-0001-5928-486X
Karim RazaRheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.

Funding

Applied Research Collaboration NorthwestBirmingham Biomedical Research CentreDepartment of Health and Social CareDevelopment and validation of Rheumatoid Arthritis PredIction moDel NIHR203621Kennedy Trust for Rheumatology ResearchNational Institute for Health ResearchNIHRNIHR Research for Patient Benefit
6 · The paper itself

Abstract

objectivesTo assess whether prodromal symptoms of RA, as recorded in the Clinical Practice Research Datalink Aurum (CPRD) database of English primary care records, differ by ethnicity and socioeconomic status.

methodsA cross-sectional study to determine the coding of common symptoms (≥0.1% in the sample) in the 24 months preceding RA diagnosis in CPRD Aurum, recorded between 1 January 2004 and 1 May 2022. Eligible cases were adults with a code for RA diagnosis. For each symptom, a logistic regression was performed with the symptom as dependent variable, and ethnicity and socioeconomic status as independent variables. Results were adjusted for sex, age, BMI and smoking status. White ethnicity and the highest socioeconomic quintile were comparators.

resultsIn total, 70 115 cases were eligible for inclusion, of which 66.4% were female. Twenty-one symptoms were coded in >0.1% of cases so were included in the analysis. Patients of South Asian ethnicity had higher frequency of codes for several symptoms, with the largest difference by odds ratio being muscle cramps (1.71, 99.76 % confidence interval 1.44-2.57) and shoulder pain (1.44, 1.25-1.66). Patients of Black ethnicity had higher prevalence of several codes including unintended weight loss (2.02, 1.25-3.28) and ankle pain (1.51, 1.02-2.23). Low socioeconomic status was associated with morning stiffness (1.74, 1.08-2.80) and falls (1.37, 2.03-1.82).

conclusionThere are significant differences in coded symptoms between demographic groups, which must be considered in clinical practice in diverse populations and to avoid algorithmic bias in prediction tools derived from routinely collected healthcare data.

Indexed as

Arthritis, RheumatoidEthnicityProdromal SymptomsSocial ClassAdultAgedCross-Sectional StudiesDatabases, FactualEnglandFemaleHumansMaleMiddle AgedPrimary Health CareUnited Kingdomhealth equityprimary carerheumatoid arthritisroutine clinical data

Identifiers

PMID38466930
PMCPMC11879358

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.