Evidence map›Paper›PMID 41553408›Full record

Observational studyClinical rheumatology2026

Signal or noise? Apply myositis autoantibody line-blot immunoassays in real-world settings: implications for diagnostic accuracy.

Pei-Hsinq Lai, Chiao-Feng Cheng, Tai-Ju Lee, Jheng-Wei Lin, Jui-Hung Kao, Ting-Wei Chang, Kuan-Yen Lin, Shao-Yu Pai, Cheng-Hsun Lu, Chieh-Yu Shen and 3 more

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Clinical rheumatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Pei-Hsinq LaiDepartment of Internal Medicine, Taipei City Hospital, Zhongxiao Branch, Taipei, Taiwan.
Chiao-Feng ChengDivision of Allergy, Immunology and Rheumatology, Department of Internal Medicine, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei City, 100, Taiwan.
Tai-Ju LeeDivision of Allergy, Immunology and Rheumatology, Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu City, Taiwan.
Jheng-Wei LinDivision of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taipei Tzu-Chi Hospital, New Taipei City, Taiwan.
Jui-Hung KaoDivision of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Shuang Ho Hospital, New Taipei City, Taiwan.
Ting-Wei ChangDivision of Allergy, Immunology and Rheumatology, Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu City, Taiwan.
Kuan-Yen LinDivision of Allergy, Immunology and Rheumatology, Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu City, Taiwan.
Shao-Yu PaiDivision of Allergy, Immunology and Rheumatology, Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu City, Taiwan.
Cheng-Hsun LuDivision of Allergy, Immunology and Rheumatology, Department of Internal Medicine, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei City, 100, Taiwan.
Chieh-Yu ShenDivision of Allergy, Immunology and Rheumatology, Department of Internal Medicine, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei City, 100, Taiwan.
Ko-Jen LiDivision of Allergy, Immunology and Rheumatology, Department of Internal Medicine, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei City, 100, Taiwan.
Song-Chou HsiehDivision of Allergy, Immunology and Rheumatology, Department of Internal Medicine, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei City, 100, Taiwan. hsiehsc@ntu.edu.tw.
Ting-Yuan LanDivision of Allergy, Immunology and Rheumatology, Department of Internal Medicine, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei City, 100, Taiwan. d20023579@gmail.com.ORCID http://orcid.org/0000-0002-2827-1692

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveInterpreting myositis autoantibody line-blot immunoassay (LIA) is challenging when balancing clinical relevance with autoantibody positivity strength. We evaluated its diagnostic values in real-world clinical practice.

methodsA retrospective observational study of consecutive myositis LIA results in National Taiwan University Hospital from April 2021 to March 2023. We categorized the LIA testing indications into: suspected IIM, single clinical domain (pulmonary, muscular, joint, skin, and cardiovascular), and autoimmune work-ups. Individual autoantibody positive predictive value (PPV) for clinically diagnosed IIM was analyzed according to testing indications.

resultsA total of 677 cases were included, 162 patients with IIM and 130 were LIA + IIM. LIA demonstrated an overall sensitivity of 80.2% and specificity of 66.4% in diagnosing IIM. Suspected IIM exhibited the highest PPV (95.9%) compared to single clinical domains or autoimmune work-ups. Autoantibody PPV was generally high in suspected IIM. Anti-aminoacyl-tRNA synthetase antibodies and anti-MDA5 exhibited higher PPV in pulmonary manifestations. Overall autoantibody PPV was low in joint, skin manifestations, and autoimmune work-ups. Pulmonary manifestation accounted for the majority of testing indications, yet few were found with IIM as the final diagnosis. Among those with LIA-seropositivity, 30.7% had autoimmune features, and 25% had other connective tissue diseases. Most anti-synthetase syndrome cases (86.7%) were in a single-domain manifestation.

conclusionThe positive predictive value of myositis autoantibodies detected by LIA varies with testing indications and autoantibody profiles, rather than autoantibody positivity strength alone. LIA seropositive non-IIM reflect evolving diseases. Amid growing concerns about potential false positives and negatives in LIA, this study emphasizes integrating clinical context and longitudinal assessment when ordering and interpreting LIA in real-world practices. Key Points • The positive predictive value (PPV) of individual myositis autoantibodies for clinically diagnosed IIM varies substantially with the testing indications and autoantibody profiles, rather than autoantibody positivity strength alone. • Most (86.7%) patients with anti-synthetase syndrome had LIA tested for only one clinical domain initially. • Integrating clinical context before testing and throughout longitudinal assessment is essential for accurate interpretation of LIA results in broader clinical applications.

Indexed as

AutoantibodiesMyositisAdultAgedFemaleHumansImmunoassayMaleMiddle AgedPredictive Value of TestsRetrospective StudiesSensitivity and SpecificityTaiwanAutoantibodiesAutoantibodiesImmunoassayMyositisPredictive value of tests

Identifiers

PMID41553408

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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.