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Rheumatoid Arthritis Diagnostic and Monitoring Testing Patterns by Physicians and Advanced Practice Providers in the
Min Kyung Lee1, Karis Lee1, David Alfego1
1Labcorp, Burlington, North Carolina.
ACR Open Rheumatology
|February 22, 2026
Summary
Advanced practice providers (APPs) significantly increased rheumatoid arthritis (RA) test ordering, showing a substantial rise in diagnostic and monitoring contributions. This trend reflects their expanding role in rheumatology care.
Area of Science:
- Rheumatology
- Clinical Diagnostics
- Healthcare Workforce Analysis
Background:
- Rheumatoid arthritis (RA) diagnosis and monitoring rely heavily on laboratory testing.
- Physicians and advanced practice providers (APPs) play crucial roles in managing RA patients.
- Understanding longitudinal trends in test ordering by different provider types is essential for optimizing RA care pathways.
Purpose of the Study:
- To investigate longitudinal trends in rheumatoid arthritis (RA) diagnosis and monitoring test ordering.
- To compare ordering patterns between physicians and APPs in primary care and rheumatology settings.
- To analyze the impact of emerging diagnostic markers and panel tests on RA assessment.
Main Methods:
- Retrospective review of RA-associated laboratory tests ordered through Labcorp (2012-2024).
- Analysis included data from 7,026 physicians and 2,188 APPs across primary care and rheumatology.
- Included conventional markers (RF, anti-CCP), emerging markers, and panel tests for diagnosis, plus Vectra tests for monitoring.
Main Results:
- Rheumatology APP test ordering increased by 411.8%, significantly outpacing the 58.5% growth among rheumatology physicians.
- APPs ordered fewer conventional markers but more monitoring tests compared to physicians.
- RA panel test volumes saw dramatic increases, especially among APPs (2,948.5% rise).
- The disparity in positive diagnostic test results between rheumatology physicians and APPs narrowed considerably.
Conclusions:
- Advanced practice providers (APPs) demonstrate a significant and growing contribution to rheumatoid arthritis (RA) diagnostic and monitoring test ordering.
- The observed trends align with the increasing presence and integration of APPs within the rheumatology workforce.
- These findings highlight the evolving landscape of RA patient management and the role of APPs in laboratory test utilization.
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