OBJECTIVE: Matrix-based risk models have been proposed as a tool to predict rapid radiographic progression (RRP) in rheumatoid arthritis (RA), but the experience with such models is limited. We tested the performance of 3 risk models for RRP in an observational cohort. METHODS: Subjects from an observational RA cohort with hand radiographs and necessary predictor variables to be classified by the risk models were identified (n = 478). RRP was defined as a yearly change in the Sharp/van der Heijde score of ≥5 units. Patients were placed in the appropriate matrix categories, with a corresponding predicted risk of RRP. The mean predicted probability for cases and noncases, integrated discrimination improvement, Hosmer-Lemeshow statistics, and C statistics were calculated. RESULTS: The median age was 59 years (interquartile range [IQR] 50-66 years), the median disease duration was 12 years (IQR 4-23 years), the median swollen joint count was 6 (IQR 2-13), 84% were women, and 86% had erosions at baseline. Twelve percent of patients (32 of 271) treated with synthetic disease-modifying antirheumatic drugs (DMARDs) at baseline and 10% of patients (21 of 207) treated with biologic DMARDs experienced RRP. Most of the predictor variables had a skewed distribution in the population. All models had a suboptimal performance when applied to this cohort, with C statistics of 0.59 (model A), 0.65 (model B), and 0.57 (model C), and Hosmer-Lemeshow chi-square P values of 0.06 (model A), 0.005 (model B), and 0.05 (model C). CONCLUSION: Matrix risk models developed in clinical trials of patients with early RA had limited ability to predict RRP in this observational cohort of RA patients.
OBJECTIVE: Matrix-based risk models have been proposed as a tool to predict rapid radiographic progression (RRP) in rheumatoid arthritis (RA), but the experience with such models is limited. We tested the performance of 3 risk models for RRP in an observational cohort. METHODS: Subjects from an observational RA cohort with hand radiographs and necessary predictor variables to be classified by the risk models were identified (n = 478). RRP was defined as a yearly change in the Sharp/van der Heijde score of ≥5 units. Patients were placed in the appropriate matrix categories, with a corresponding predicted risk of RRP. The mean predicted probability for cases and noncases, integrated discrimination improvement, Hosmer-Lemeshow statistics, and C statistics were calculated. RESULTS: The median age was 59 years (interquartile range [IQR] 50-66 years), the median disease duration was 12 years (IQR 4-23 years), the median swollen joint count was 6 (IQR 2-13), 84% were women, and 86% had erosions at baseline. Twelve percent of patients (32 of 271) treated with synthetic disease-modifying antirheumatic drugs (DMARDs) at baseline and 10% of patients (21 of 207) treated with biologic DMARDs experienced RRP. Most of the predictor variables had a skewed distribution in the population. All models had a suboptimal performance when applied to this cohort, with C statistics of 0.59 (model A), 0.65 (model B), and 0.57 (model C), and Hosmer-Lemeshow chi-square P values of 0.06 (model A), 0.005 (model B), and 0.05 (model C). CONCLUSION: Matrix risk models developed in clinical trials of patients with early RA had limited ability to predict RRP in this observational cohort of RApatients.
Authors: F C Arnett; S M Edworthy; D A Bloch; D J McShane; J F Fries; N S Cooper; L A Healey; S R Kaplan; M H Liang; H S Luthra Journal: Arthritis Rheum Date: 1988-03
Authors: Ewout W Steyerberg; Andrew J Vickers; Nancy R Cook; Thomas Gerds; Mithat Gonen; Nancy Obuchowski; Michael J Pencina; Michael W Kattan Journal: Epidemiology Date: 2010-01 Impact factor: 4.822
Authors: Nathan Vastesaeger; Stephen Xu; Daniel Aletaha; E William St Clair; Josef S Smolen Journal: Rheumatology (Oxford) Date: 2009-07-09 Impact factor: 7.580
Authors: Nathan Vastesaeger; Désirée van der Heijde; Robert D Inman; Yanxin Wang; Atul Deodhar; Benjamin Hsu; Mahboob U Rahman; Ben Dijkmans; Piet Geusens; Bert Vander Cruyssen; Eduardo Collantes; Joachim Sieper; Jürgen Braun Journal: Ann Rheum Dis Date: 2011-03-14 Impact factor: 19.103
Authors: Maria D Mjaavatten; Helga Radner; Kazuki Yoshida; Nancy A Shadick; Michelle L Frits; Christine K Iannaccone; Tore K Kvien; Michael E Weinblatt; Daniel H Solomon Journal: J Rheumatol Date: 2014-10-15 Impact factor: 4.666
Authors: Bruno Fautrel; Benjamin Granger; Bernard Combe; Alain Saraux; Francis Guillemin; Xavier Le Loet Journal: Arthritis Res Ther Date: 2012-11-19 Impact factor: 5.156
Authors: Saedis Saevarsdottir; Hamed Rezaei; Pierre Geborek; Ingemar Petersson; Sofia Ernestam; Kristina Albertsson; Kristina Forslind; Ronald F van Vollenhoven Journal: Ann Rheum Dis Date: 2014-04-04 Impact factor: 19.103
Authors: Wanying Li; Eric H Sasso; Annette H M van der Helm-van Mil; Tom W J Huizinga Journal: Rheumatology (Oxford) Date: 2015-09-18 Impact factor: 7.580
Authors: Robert B M Landewé; Carol A Connell; John D Bradley; Bethanie Wilkinson; David Gruben; Sander Strengholt; Désirée van der Heijde Journal: Arthritis Res Ther Date: 2016-09-23 Impact factor: 5.156