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Correspondence
Anticitrullinated protein antibodies: taking into account antibody levels improves interpretation
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  1. Xavier Bossuyt1,2
  1. 1 Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
  2. 2 Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
  1. Correspondence to Dr Xavier Bossuyt, Herestraat 49, B-3000 Leuven, Belgium; Xavier.bossuyt{at}uzleuven.be

https://doi.org/10.1136/annrheumdis-2016-211039

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    Hensvold et al 1 reported on the discriminatory capacity of anticitrullinated protein antibodies (ACPA) for diagnosing rheumatoid arthritis (RA).1 A major strength of the study is that it was performed in a population setting and that a large number of controls (n=12 434) were included, thereby allowing a reliable estimate of the specificity of ACPA. The authors give detailed information on the diagnostic performance of anti-CCP2 antibodies (Euro-Diagnostica) for two cut-off points, namely the cut-off point recommended by the manufacturer and a cut-off point that is three times higher than the manufacturer's cut-off point. The latter high cut-off was defined in accordance to the European League against Rheumatism/American College of Rheumatology 2010 RA classification criteria.2 The authors show that the positive likelihood ratio (LR) was higher for the high cut-off (LR=74) than for …

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