STEVEN CUMMINGS, M.D.; PAUL HEINECKEN, M.D.; PAUL FEIGENBAUM, M.D.
To the editor: Although we generally agree with Richardson and Epstein's analysis of the limits of the clinical utility of the fluorescent antinuclear antibody test (1), their review contains three potentially misleading points.
First, we do not believe that a general internist's patient who has four American Rheumatism Association (ARA) clinical criteria for the diagnosis of systemic lupus erythematosus has only a 5% chance of having the disease. A woman with nondeforming inflammatory arthritis, malar rash, glomerulonephritis, and pleuropericarditis very likely has systemic lupus erythematosus in any practice situation. To arrive at their estimates, Richardson and Epstein applied specificity values
CUMMINGS S, HEINECKEN P, FEIGENBAUM P. Utility of the Fluorescent Antinuclear Antibody Test. Ann Intern Med. ;96:258–259. doi: 10.7326/0003-4819-96-2-258_2
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Published: Ann Intern Med. 1982;96(2):258-259.
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