THE RHEUMATOID-FACTOR - AN ANALYSIS OF CLINICAL UTILITY

被引:159
|
作者
SHMERLING, RH
DELBANCO, TL
机构
[1] CHARLES A DANA RES INST, BOSTON, MA USA
[2] HARVARD UNIV, BETH ISRAEL HOSP, SCH MED, DEPT MED, DIV RHEUMATOL, BOSTON, MA 02215 USA
[3] HARVARD THORNDIKE LAB, BOSTON, MA USA
[4] HARVARD UNIV, SCH MED, CHARLES A DANA RES INST, DIV GEN MED & PRIMARY CARE, BOSTON, MA 02115 USA
来源
AMERICAN JOURNAL OF MEDICINE | 1991年 / 91卷 / 05期
关键词
D O I
10.1016/0002-9343(91)90190-9
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The rheumatoid factor (RF) is a frequently ordered diagnostic test, yet it possesses significant limitations in sensitivity, specificity, and predictive value. Recognition of these limitations could improve the test's utility by encouraging more selective test ordering and more circumspect interpretation of test results. An analysis of 563 requests for RF from a teaching hospital revealed a positive predictive value of only 24% to 34%. The RF performs best under conditions of moderate pretest likelihood of rheumatoid arthritis, and otherwise has rather limited clinical utility.
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页码:528 / 534
页数:7
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