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2013 classification criteria for systemic sclerosis: an American College of Rheumatology/European League against Rheumatism collaborative initiative
- Source :
- Arthritis and Rheumatism, 65, 2737-47, Annals of the Rheumatic Diseases, 72, 11, pp. 1747-55, Annals of the Rheumatic Diseases, 72, 1747-55, Arthritis and Rheumatism, 65, 11, pp. 2737-47
- Publication Year :
- 2013
-
Abstract
- Objective The 1980 American College of Rheumatology (ACR) classification criteria for systemic sclerosis (SSc) lack sensitivity for early SSc and limited cutaneous SSc. The present work, by a joint committee of the ACR and the European League Against Rheumatism (EULAR), was undertaken for the purpose of developing new classification criteria for SSc. Methods Using consensus methods, 23 candidate items were arranged in a multicriteria additive point system with a threshold to classify cases as SSc. The classification system was reduced by clustering items and simplifying weights. The system was tested by 1) determining specificity and sensitivity in SSc cases and controls with scleroderma-like disorders, and 2) validating against the combined view of a group of experts on a set of cases with or without SSc. Results It was determined that skin thickening of the fingers extending proximal to the metacarpophalangeal joints is sufficient for the patient to be classified as having SSc; if that is not present, 7 additive items apply, with varying weights for each: skin thickening of the fingers, fingertip lesions, telangiectasia, abnormal nailfold capillaries, interstitial lung disease or pulmonary arterial hypertension, Raynaud's phenomenon, and SSc-related autoantibodies. Sensitivity and specificity in the validation sample were, respectively, 0.91 and 0.92 for the new classification criteria and 0.75 and 0.72 for the 1980 ACR classification criteria. All selected cases were classified in accordance with consensus-based expert opinion. All cases classified as SSc according to the 1980 ACR criteria were classified as SSc with the new criteria, and several additional cases were now considered to be SSc. Conclusion The ACR/EULAR classification criteria for SSc performed better than the 1980 ACR criteria for SSc and should allow for more patients to be classified correctly as having the disease. Copyright © 2013 by the American College of Rheumatology.
- Subjects :
- Male
2745 Rheumatology
Acr criteria
Telangiectasi
2736 Pharmacology (medical)
Immunology and Allergy
Pharmacology (medical)
Familial Primary Pulmonary Hypertension
skin and connective tissue diseases
integumentary system
Skin thickening
Diagnosis-Related Group
Interstitial lung disease
10051 Rheumatology Clinic and Institute of Physical Medicine
Middle Aged
Connective tissue disease
Autoantibodie
Europe
2723 Immunology and Allergy
Evaluation of complex medical interventions Auto-immunity, transplantation and immunotherapy [NCEBP 2]
Female
Human
United State
Adult
musculoskeletal diseases
medicine.medical_specialty
Consensus
Hypertension, Pulmonary
Immunology
Reproducibility of Result
610 Medicine & health
Consensu
Sensitivity and Specificity
General Biochemistry, Genetics and Molecular Biology
Article
Rheumatology
Point system
1300 General Biochemistry, Genetics and Molecular Biology
Scleroderma, Limited
Internal medicine
medicine
Humans
Telangiectasis
Disease Activity
Diagnosis-Related Groups
Systemic Sclerosi
Aged
Autoantibodies
2403 Immunology
Biochemistry, Genetics and Molecular Biology (all)
Scleroderma, Systemic
business.industry
Reproducibility of Results
Raynaud Disease
medicine.disease
United States
Treatment
Evaluation of complex medical interventions [NCEBP 2]
Expert opinion
Physical therapy
business
Lung Diseases, Interstitial
Rheumatism
Subjects
Details
- ISSN :
- 00043591 and 00034967
- Database :
- OpenAIRE
- Journal :
- Arthritis and Rheumatism, 65, 2737-47, Annals of the Rheumatic Diseases, 72, 11, pp. 1747-55, Annals of the Rheumatic Diseases, 72, 1747-55, Arthritis and Rheumatism, 65, 11, pp. 2737-47
- Accession number :
- edsair.doi.dedup.....0702b5a77bbd769ae5cf69445243bb0b