Open Access Open Badges Correspondence

The reporting quality of studies investigating the diagnostic accuracy of anti-CCP antibody in rheumatoid arthritis and its impact on diagnostic estimates

Elias Zintzaras12*, Afroditi A Papathanasiou1, Dimitrios C Ziogas3 and Michael Voulgarelis4

Author Affiliations

1 Department of Biomathematics, University of Thessaly School of Medicine, 2 Panepistimiou Str, Larissa, 41110, Greece

2 The Institute for Clinical Research and Health Policy Studies, Tufts-New England Medical Center, Tufts University School of Medicine, Boston, USA

3 Department of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

4 Department of Pathophysiology, National University of Athens School of Medicine, Athens, Greece

For all author emails, please log on.

BMC Musculoskeletal Disorders 2012, 13:113  doi:10.1186/1471-2474-13-113

Published: 25 June 2012



Recently anti-CCP testing has become popular in the diagnosis of rheumatoid arthritis (RA). However, the inadequate reporting of the relevant diagnostic studies may overestimate and bias the results, directing scientists into making false decisions. The aim of the present study was to evaluate the reporting quality of studies used anti-CCP2 for the diagnosis of RA and to explore the impact of reporting quality on pooled estimates of diagnostic measures.


PubMed was searched for clinical studies investigated the diagnostic accuracy of anti-CCP. The studies were evaluated for their reporting quality according to STARD statement. The overall reporting quality and the differences between high and low quality studies were explored. The effect of reporting quality on pooled estimates of diagnostic accuracy was also examined.


The overall reporting quality was relatively good but there are some essential methodological aspects of the studies that are seldom reported making the assessment of study validity difficult. Comparing the quality of reporting in high versus low quality articles, significant differences were seen in a relatively large number of methodological items. Overall, the STARD score (high/low) has no effect on the pooled sensitivities and specificities. However, the reporting of specific STARD items (e.g. reporting sufficiently the methods used in calculating the measures of diagnostic accuracy and reporting of demographic and clinical characteristics/features of the study population) has an effect on sensitivity and specificity.


The reporting quality of the diagnostic studies needs further improvement since the study quality may bias the estimates of diagnostic accuracy.

Rheumatoid arthritis; Anti-cyclic citrullinated peptide 2; Anti-CCP2; Quality, Sensitivity; Specificity, Meta-analysis