Selection biases (hospital series versus series followed in the community), follow-up (tendency to include more serious patients in the studies, who come more to the consultation), classification (relative low specificity of the criteria of the ACR at the time of analyzing initial polyarthritis Hondrocream, etc. These and other biases may be involved to a greater or lesser degree in all the studies on prognostic factors.
Influence of the treatment: the natural history of RA can not be established today independently of antirheumatic therapy. Many of the studies conducted on prognostic factors do not adequately analyze the therapeutic strategy used.
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