Van Hoovels L, Vander Cruyssen B, Sieghart D, et al. A multicenter study to improve clinical interpretation of rheumatoid factor and anti-citrullinated protein/peptide antibodies test results. RMD Open 2022;8:e002099.
We noticed some errors in the reported 95% confidence intervals (95% CI) of the likelihood ratios of ACPA IgG for rheumatoid arthritis. All 95% CI were verified using the Newcombe-Wilson method.1 table 4 with the corrected 95% CI of the likelihood ratios is given below.
Table 4. ACPA test result-specific likelihood ratios.
| Interval | Fraction of controls | Fraction of patients | LR | 95% CI | |
|---|---|---|---|---|---|
| Thermo Fisher | < 3.3 | 0.902 | 0.299 | 0.33 | 0.29–0.39 |
| ACPA | 3.3–9.5 | 0.073 | 0.065 | 0.90 | 0.59–1.38 |
| CO=10 U/mL | 9.5–79.8 | 0.015 | 0.133 | 8.93 | 5.17–15.43 |
| 79.8–324.6 | 0.007 | 0.204 | 27.30 | 13.32–55.92 | |
| 324.6-≥340.0 | 0.003 | 0.299 | 106.90 | 34.20–334.37 | |
| Roche ACPA | < 3.5 | 0.955 | 0.362 | 0.38 | 0.33–0.43 |
| CO=17 U/mL | 3.5–36.1 | 0.020 | 0.030 | 1.54 | 0.77–3.10 |
| 36.1–230.4 | 0.015 | 0.193 | 12.97 | 7.67–21.96 | |
| 230.4 -≥500.0 | 0.010 | 0.415 | 40.44 | 22.21–73.64 | |
| Svar ACPA | < 4.3 | 0.898 | 0.352 | 0.39 | 0.34–0.45 |
| CO=25 U/mL | 4.3–26.6 | 0.076 | 0.035 | 0.46 | 0.26–0.80 |
| 26.6–147.8 | 0.015 | 0.113 | 7.58 | 4.34–13.26 | |
| 147.8–398.0 | 0.007 | 0.226 | 30.33 | 14.85–61.93 | |
| 398.0 -≥3200.0 | 0.003 | 0.273 | 97.95 | 31.29–306.68 | |
| IDS ACPA | < 2.0 | 0.904 | 0.281 | 0.31 | 0.27–0.37 |
| CO=5 AU/mL | 2.0–7.7 | 0.071 | 0.100 | 1.41 | 0.99–2.04 |
| 7.7–43.4 | 0.015 | 0.121 | 8.08 | 4.65–14.07 | |
| 43.4–236.8 | 0.007 | 0.273 | 36.73 | 18.08–74.62 | |
| 236.8 -≥320.0 | 0.003 | 0.224 | 79.98 | 25.46–251.27 | |
| Orgentec | < 5.8 | 0.900 | 0.314 | 0.35 | 0.30–0.40 |
| ACPA | 5.8–14.7 | 0.075 | 0.080 | 1.08 | 0.73–1.60 |
| CO=20 U/mL | 14.7–137.7 | 0.015 | 0.156 | 10.45 | 6.10–17.88 |
| 137.7–926.0 | 0.007 | 0.178 | 23.93 | 11.63–49.25 | |
| 926.0 -≥1000.0 | 0.003 | 0.271 | 97.06 | 31.00–303.91 | |
| Abbott ACPA | < 1.0 | 0.913 | 0.314 | 0.34 | 0.30–0.40 |
| CO=5 U/mL | 2.7–4.5 | 0.062 | 0.063 | 1.02 | 0.65–1.60 |
| 4.5–53.1 | 0.015 | 0.186 | 12.47 | 7.35–21.14 | |
| 53.1–188.2 | 0.007 | 0.186 | 24.94 | 12.13–51.25 | |
| 188.2 -≥196.0 | 0.003 | 0.251 | 89.87 | 28.66–281.74 | |
| Euroimmun | < 3.0 | 0.901 | 0.319 | 0.35 | 0.31–0.41 |
| ACPA | 3.0–9.9 | 0.074 | 0.070 | 0.96 | 0.63–1.45 |
| CO=5 RU/mL | 9.9–37.5 | 0.015 | 0.106 | 7.08 | 4.03–12.44 |
| 37.5–187.7 | 0.007 | 0.276 | 37.07 | 18.25–75.28 | |
| 187.7 -≥200.0 | 0.003 | 0.229 | 81.78 | 26.04–256.81 | |
| BioRad ACPA | < 1.5 | 0.912 | 0.334 | 0.37 | 0.32–0.43 |
| CO=3 RU/mL | 1.5–5.5 | 0.063 | 0.077 | 1.22 | 0.80–1.88 |
| 5.5–127.5 | 0.015 | 0.160 | 10.63 | 6.11–18.53 | |
| 127.5 -≥300.0 | 0.010 | 0.428 | 42.65 | 22.76–79.92 | |
| Siemens | < 1.1 | 0.904 | 0.273 | 0.30 | 0.26–0.36 |
| ACPA | 1.1–5.6 | 0.071 | 0.094 | 1.32 | 0.89–1.95 |
| CO=5 U/mL | 5.6–57.8 | 0.015 | 0.155 | 10,27 | 5.89–17.93 |
| 57.8 -≥200.0 | 0.010 | 0.478 | 47.60 | 25.45–89.02 |
For RF (table 3), the 95% CI for the likelihood ratio of the Ortho RF interval 16.3–18.7 IU/mL should be 1.03–3.24 instead of 1.07–3.37.
Reference
- 1.Newcombe RG Interval estimation for the difference between independent proportions: comparison of eleven methods. Statist Med. 1998;17:873–90. doi: 10.1002/(SICI)1097-0258(19980430)17:8<873::AID-SIM779>3.0.CO;2-I. [DOI] [PubMed] [Google Scholar]
