A CROSS-SECTIONAL AND LONGITUDINAL COMPARISON OF THE ROME CRITERIA FOR ACTIVE RHEUMATOID-ARTHRITIS (EQUIVALENT TO THE AMERICAN-COLLEGE-OF-RHEUMATOLOGY 1958 CRITERIA) AND THE AMERICAN-COLLEGE-OF-RHEUMATOLOGY 1987 CRITERIA FOR RHEUMATOID-ARTHRITIS

Objective. To compare the diagnostic properties of the Rome 1961 crite ria for active rheumatoid arthritis (RA) and the American College of R heumatology (ACR; formerly, the American Rheumatism Association) 1987 criteria for RA with regard to their ability to classify, diagnose, an d predict outcome in RA. Methods. Analysis of cross-sectional and long itudinal data from repeated health examinations and review of clinical records of 3,509 Pima Indians followed up from January 1966 to Decemb er 1990. Results. The ACR 1987 criteria identified similar to 50% of t he cases identified by the Rome 1961 criteria, in both cross-sectional and longitudinal analyses. The ACR 1987 criteria were better predicto rs of subsequent development of a clinically supported diagnosis and t reatment with slow-acting antirheumatic drugs (both P < 0.001), but we re less sensitive than the Rome 1961 criteria for detecting cases for which there already was a clinically supported diagnosis (P < 0.001). Conclusion. In a population-based analysis, the ACR 1987 criteria are less sensitive for detecting clinical disease, but predict a clinicall y more severe prognosis, compared with the Rome 1961 criteria. The sen sitivity of both sets of criteria to identify clinical disease is impr oved if multiple examinations or inactive disease are taken into accou nt.