Even if we agree with the conclusions of Narain et al1 that systemic autoimmune diseases are often misdiagnosed in primary care settings, exposing some of these patients to receive toxic medications, we think that the methods used do not support this assertion because of several important limitations. First, the patients were examined by 1 of 4 clinicians, of whom 2 were also the experts who decided on the final diagnosis. A correct procedure should have been an independent panel not implicated in the patient’s care deciding on the definitive diagnosis.
Goichot B, Vinzio S. Diagnostic Accuracy in Systemic Autoimmune Diseases. Arch Intern Med. 2005;165(12):1438–1439. doi:10.1001/archinte.165.12.1438-b