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Agmon-Levin et al1 formulated recommendations for the assessment of antinuclear antibodies (ANA). Indirect immunofluorescence (IIF) is considered the reference method for ANA screening, which is in agreement with the American College of Rheumatology (ACR) position statement.2 The recommendations are based on current knowledge and expert experience. However, as recognised by Meroni and Schur,2 no well-planned studies comparing the diagnostic accuracy of the old IIF and the new methods have been undertaken.
In a recent study, IIF was compared to a new automated method for connective disease screening (fluoroenzymeimmunoassay (FEIA) (EliA CTD screen, Thermo Fisher)) using samples obtained at the time of diagnosis from well-characterised patients and controls.3 Diagnostic accuracy data (for systemic lupus erythematosus (SLE), systemic sclerosis (SSc) and Sjögren's syndrome (SS)) from this study is recapitulated in table 1. …