Diagnostic strategies for autoimmune rheumatic diseases

In order to help the clinical rheumatologist set an early and precise diagnosis and plan a rational follow-up, a close collaboration between all parties involved in the diagnostic work-up must be established. Autoimmune serology plays a key role in achieving this goal by choosing test methods that are ideal from a clinical standpoint and by presenting results obtained in such a fashion that even less experienced clinicians can correctly use the information. Simple algorithms for test ordering and for the interpretation of laboratory findings are of great benefit in daily practice, but such tools must be mutually agreed upon by the laboratory and clinical scientists. A precise diagnosis and estimation of prognosis is instrumental for optimal decision making in the clinic, but this is too complicated to be left to chance due to the inappropriate use of information. Late or wrong decisions during follow-up lead to unnecessary suffering and far higher lifetime costs for chronic diseases such as those found in rheumatology.