Observational Health Data Sciences and Informatics

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==== Summary ====


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=== Phenotype: Rheumatoid Arthritis ===

**Version:** 1.1

**Date Submitted:** October 1, 2018

**Date Approved:** October 23, 2018

**Author(s):** Jeff Smith, MD

**Organization:** Wincester Institute, Scotland, UK

**Modality:**  (Rule-Based or Computational)

**Current Implementation:** [[http://www.ohdsi.org/web/atlas/#/cohortdefinition/100145}Atlas Phenotype]]

==== Description ====


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== Objective ==

This definition is intended to capture patients with a first-observed diagnosis of chronic rheumatoid arthritis (RA), taking care to rule out patients with short-term joint pain or fibromyalgia.

== Development Process ==

This phenotype was developed by a group of 4 expert rheumatologists, who gathered and identified key condition codes that manifest in individuals with RA, along with drug combinations that almost exclusively identify RA patients.

== Version Log ==

^Date (MM/DD/YYYY)^Version^Description                                                                   ^Link  ^
|10/11/2018       |1.1    |Included extra RA descendents introduced in newly released OMOP CDM Version 6.|(Link)|
|10/01/2018       |1.0    |Initial Release                                                               |(Link)|

==== Performance ====


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The phenotype has been validated at the following sites, with the following metrics:

^Site^Sample Size^TP^FP^TN^FN^Sensitivity^Specificity^PPV^NPV^
|A   |           |  |  |  |  |           |           |   |   |
|B   |           |  |  |  |  |           |           |   |   |
|C   |           |  |  |  |  |           |           |   |   |

TP = True Positive FP = False Positive TN = True Negative FN = False Negative PPV = Positive Predictive Value NPV = Negative Predictive Value

== Sites ==

Site A represents a large Midwestern academic medical center. Site B is a hospital in a mostly rural area in the Southeastern US. Site C represents proprietary EU patient data licensed by a large research organization

== Validation Procedure ==

At each site, chart review was independently performed by 2 rheumatologists on a randomly selected subset (5%) of patients satisfying the phenotype definition.

== Site-Specific Comments ==

At Site B, the small sample size was likely due to a lack of an on-site rheumatology clinic.

==== Additional Information ====


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== Known Caveats or Cautions ==

  * Alternative blood tests besides C-reactive protein may be used to diagnose RA in some cases.
  * Rheumatoid arthritis is known to disproportionately affect women more than men; hence, the resulting sample will not be expected to be balanced across gender.

== Supplemental Information (optional) ==

i.e. Flowcharts or other diagrams that may be helpful to an end user

== Comments ==

This phenotype will be re-reviewed in October 2022.

==== Citations ====


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