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Rheumatoid Arthritis referral criteria

2026-02Recensão Acesso aberto
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dc.contributor.authorMadruga Dias, João
dc.contributor.authorRibeiro, Raquel
dc.contributor.authorCosta, Teresa
dc.contributor.authorSilvério Serra, Sofia
dc.contributor.authorSilva, Sónia
dc.contributor.authorIagnocco, Annamaria
dc.contributor.authorCanhão, Helena
dc.contributor.authorPimentel-Santos, Fernando
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.institutionComprehensive Health Research Centre (CHRC) - pólo NMS
dc.contributor.institutioniNOVA4Health - pólo NMS
dc.contributor.pblBioMed Central (BMC)
dc.date.accessioned2026-02-09T16:10:02Z
dc.date.available2026-02-09T16:10:02Z
dc.date.issued2026-02
dc.descriptionPublisher Copyright: © The Author(s) 2025.
dc.description.abstractIntroduction: Timely referral in Rheumatoid Arthritis (RA) is critical for early diagnosis and initiation of treatment, which are crucial to improve patient outcomes and limit radiographic progression. Optimized referral criteria, whether applied by clinicians or healthcare artificial intelligence systems, can facilitate faster and more accurate decisions regarding patient assessment by a Rheumatologist. Despite this need, a validated and widely adopted referral tool for RA is still lacking. Objective: To compile and analyse all available RA referral criteria since January 2001 until October 2023. Methods: We searched PubMed, Scopus and Web of Science in the considered period, using a defined set of strings. Studies were only included if they provided RA referral criteria or Inflammatory/Early Arthritis criteria directed at RA diagnosis. Results: We identified 19 publications. Most include symptoms in referral criteria, either arthralgia or stiffness (63%) and only 16% considered constitutional symptoms such as fever, fatigue or weight loss. However, the most prevalent criteria for referral is swollen joints (79%), while tender joints are included in 63% and squeeze test assessment in 33%. Regarding laboratory tests, rheumatoid factor is considered in 53% of referral criteria, while ACPA in 32%. Nearly half of the referral criteria consider inflammatory markers (CRP and/or ESR). Family history is present in 21% of the cases. Discussion: Published RA referral criteria encompass several components (symptoms, signs, laboratory and family history), but none were validated in a large cohort of patients. The vast majority, were either part of recommendations, published guidelines or based in expert opinion. There is an unmet need for evidence-based validated RA referral criteria. PROSPERO register: CRD42024499423.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent1833082
dc.identifier.doi10.1186/s41927-025-00602-y
dc.identifier.issn2520-1026
dc.identifier.otherPURE: 152451148
dc.identifier.otherPURE UUID: a3632003-f98b-442a-a196-76f3b52a82ad
dc.identifier.otherScopus: 105028507865
dc.identifier.urihttp://hdl.handle.net/10362/200149
dc.identifier.urlhttps://www.scopus.com/pages/publications/105028507865
dc.language.isoeng
dc.peerreviewedyes
dc.subjectCriteria
dc.subjectEarly arthritis
dc.subjectPrimary care
dc.subjectReferral
dc.subjectRheumatoid arthritis
dc.subjectSystematic review
dc.subjectRheumatology
dc.titleRheumatoid Arthritis referral criteriaen
dc.title.subtitlesystematic review of the literatureen
dc.typereview
degois.publication.issue1
degois.publication.titleBMC Rheumatology
degois.publication.volume10
dspace.entity.typePublication
rcaap.rightsopenAccess

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