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Table 3 Test characteristics of multiple algorithms among patients ≥ 20 y

From: An administrative data validation study of the accuracy of algorithms for identifying rheumatoid arthritis: the influence of the reference standard on algorithm performance

Algorithms [Pretest prevalence: 0.9%] TP TN FN FP Post-test prev.# Sensitivity [95 CI%] Specificity [95 CI%] PPV [95 CI%] NPV [95 CI%]
1 H ever 15 7429 54 2 0.2% 22 (12–32) 100 (100–100) 88 (73–100) 99 (99–100)
1 H ever OR 1 ER ever 16 7427 53 4 0.3% 23 (13–33) 100 (100–100) 80 (63–98) 99 (99–100)
1 P ever 62 7188 7 243 4.1% 90 (83–97) 97 (96–97) 20 (16–25) 100 (100–100)
1 P ever by a specialist 56 7377 13 54 1.5% 81 (72–90) 99 (99–100) 51 (42–60) 100 (100–100)
2 P by any physician in 1 YR 58 7363 11 68 1.7% 84 (75–93) 99 (99–99) 46 (37–55) 100 (100–100)
2 P by any physician in 2 YR 58 7359 11 72 1.7% 84 (75–93) 99 (99–99) 45 (36–53) 100 (100–100)
2 P by any physician in 3 YR 58 7352 11 79 1.8% 84 (75–93) 99 (99–99) 42 (34–51) 100 (100–100)
3 P by any physician in 1 YR 55 7398 14 33 1.2% 80 (70–89) 100 (99–100) 63 (52–73) 100 (100–100)
3 P by any physician in 2 YR 55 7395 14 54 1.2% 80 (70–89) 100 (99–100) 60 (50–71) 100 (100–100)
3 P by any physician in 3 YR 55 7393 14 38 1.2% 80 (70–89) 100 (99–100) 59 (49–69) 100 (100–100)
2 P with ≥ 1 P by a specialist in 1 YR 54 7404 15 27 1.1% 78 (69–88) 100 (100–100) 67 (56–77) 100 (100–100)
2 P with ≥ 1 P by a specialist in 2 YR 54 7404 15 27 1.1% 78 (69–88) 100 (100–100) 67 (56–77) 100 (100–100)
2 P with ≥ 1 P by a specialist in 3 YR 54 7401 15 30 1.1% 78 (69–88) 100 (100–100) 64 (54–75) 100 (100–100)
3 P with ≥ 1 P by a specialist in 1 YR 53 7419 16 12 0.9% 77 (67–87) 100 (100–100) 82 (72–91) 100 (100–100)
3 P with ≥ 1 P by a specialist in 2 YR 53 7418 16 13 0.9% 77 (67–87) 100 (100–100) 80 (71–90) 100 (100–100)
3 P with ≥ 1 P by a specialist in 3 YR 53 7418 16 13 0.9% 77 (67–87) 100 (100–100) 80 (71–90) 100 (100–100)
(1 H ever) OR (2 P with ≥ 1 P by a specialist in 1 YR) 55 7403 14 28 1.1% 80 (70–89) 100 (100–100) 66 (56–76) 100 (100–100)
(1 H ever) OR (2 P with ≥ 1 P by a specialist in 2 YR) 55 7403 14 28 1.1% 80 (70–89) 100 (100–100) 66 (56–76) 100 (100–100)
(1 H ever) OR (2 P with ≥ 1 P by a specialist in 3 YR) 55 7400 14 31 1.1% 80 (70–89) 100 (99–100) 64 (54–74) 100 (100–100)
(1 H ever) OR (3 P with ≥1 P by a specialist in 1 YR) 54 7417 15 14 0.9% 78 (69–88) 100 (100–100) 79 (70–89) 100 (100–100)
(1 H ever) OR (3 P with ≥1 P by a specialist in 2 YR) 54 7416 15 15 0.9% 78 (69–88) 100 (100–100) 78 (69–88) 100 (100–100)
(1 H ever) OR (3 P with ≥1 P by a specialist in 3 YR) 54 7416 15 15 0.9% 78 (69–88) 100 (100–100) 78 (69–88) 100 (100–100)
(1 H ever) OR (2 P ≥ 8 weeks apart in 2 YR, no exclusions* 57 7378 12 53 1.5% 83 (74–92) 99 (99–100) 52 (43–61) 100 (100–100)
(1 H ever) OR (2 P ≥ 8 weeks apart in 2 YR) excluding Case A or Case B 41 7401 28 30 0.9% 59 (48–71) 100 (100–100) 58 (46–69) 100 (100–100)
(1 H ever) OR (2 P ≥ 8 weeks apart in 3 YR) excluding Case A or Case B 41 7396 28 35 1.0% 59 (48–71) 100 (99–100) 54 (43–65) 100 (100–100)
(1 H ever) OR (2 P ≥ 8 weeks apart in 4 YR) excluding Case A or Case B 43 7394 26 37 1.1% 62 (51–74) 100 (99–100) 54 (43–65) 100 (100–100)
(1 H ever) OR (2 P ≥ 8 weeks apart in 5 YR) excluding Case A or Case B 44 7390 25 41 1.1% 64 (52–75) 99 (99–100) 52 (41–62) 100 (100–100)
(1 H ever) OR (2 P ≥ 8 weeks apart in 2 YR) excluding Case A 41 7402 28 29 0.9% 59 (48–71) 100 (100–100) 59 (47–70) 100 (100–100)
  1. All Ages: N = 7500 patients (69 RA and 7431 non-RA); # = Post-test prevalence; TP = True Positive; TN = True Negative; FN = False Negative; FP = False Positive
  2. H: Hospitalization diagnosis code; P = physician diagnosis code; Specialist = rheumatologist, internal medicine, orthopedic surgeon; *Exclusions: Case A: Patients with ≥ 2 P with another rheumatology diagnosis subsequent to an RA diagnosis OR Case B: Patients for which the diagnosis of RA was not confirmed by a specialist. Other rheumatology diagnoses include: Osteoarthritis (715), Gout (274, 712), Polymyalgia Rheumatica (725), other seronegative spondyloarthropathy (721), Ankylosing spondylitis (720), psoriasis (696), synovitis/tenosynovitis/bursitis (727), connective tissue disorder (710), vasculitis (446), others (716; 718; 728; 727; 728; 729; 781).