학술논문
2017 European League Against Rheumatism/American College of Rheumatology Classification Criteria for Adult and Juvenile Idiopathic Inflammatory Myopathies and Their Major Subgroups.
Document Type
Academic Journal
Author
Lundberg IE; Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.; Tjärnlund A; Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.; Bottai M; Karolinska Institutet, Stockholm, Sweden.; Werth VP; Philadelphia VA Medical Center and Hospital of the University of Pennsylvania, Philadelphia.; Pilkington C; Great Ormond Street Hospital for Children NHS Trust, London, UK.; de Visser M; Academic Medical Centre, Amsterdam, The Netherlands.; Alfredsson L; Karolinska Institutet, Stockholm, Sweden.; Amato AA; Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.; Barohn RJ; University of Kansas Medical Center, Kansas City.; Liang MH; Brigham and Women's Hospital and Boston VA Healthcare, Boston, Massachusetts.; Singh JA; Mayo Clinic College of Medicine, Rochester, Minnesota, and University of Alabama and Birmingham VA Medical Center, Birmingham, Alabama.; Aggarwal R; University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.; Arnardottir S; Karolinska Institutet, Stockholm, Sweden.; Chinoy H; Central Manchester University Hospitals NHS Foundation Trust, University of Manchester, Manchester, UK.; Cooper RG; University of Liverpool, Liverpool, UK.; Dankó K; University of Debrecen, Debrecen, Hungary.; Dimachkie MM; University of Kansas Medical Center, Kansas City.; Feldman BM; University of Toronto and The Hospital for Sick Children, Toronto, Ontario, Canada.; Garcia-De La Torre I; Hospital General de Occidente, Secretaría de Salud and University of Guadalajara, Guadalajara, Mexico.; Gordon P; King's College Hospital NHS Foundation Trust, London, UK.; Hayashi T; University of Tsukuba, Tsukuba, Japan.; Katz JD; National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland.; Kohsaka H; Tokyo Medical and Dental University, Tokyo, Japan.; Lachenbruch PA; Oregon State University, Corvallis.; Lang BA; IWK Health Centre and Dalhousie University, Halifax, Nova Scotia, Canada.; Li Y; People's Hospital of Beijing University, Beijing, China.; Oddis CV; University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.; Olesinska M; National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland.; Reed AM; Duke University, Durham, North Carolina.; Rutkowska-Sak L; Institute of Rheumatology, Warsaw, Poland.; Sanner H; Oslo University Hospital-Rikshospitalet, Oslo, Norway.; Selva-O'Callaghan A; Vall d'Hebron General Hospital, Barcelona, Spain.; Song YW; Seoul National University College of Medicine, Seoul, Republic of Korea.; Vencovsky J; Charles University, Prague, Czech Republic.; Ytterberg SR; Mayo Clinic College of Medicine, Rochester, Minnesota.; Miller FW; National Institute of Environmental Health Sciences, NIH, Bethesda, Maryland.; Rider LG; National Institute of Environmental Health Sciences, NIH, Bethesda, Maryland.
Source
Publisher: Wiley Country of Publication: United States NLM ID: 101623795 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2326-5205 (Electronic) Linking ISSN: 23265191 NLM ISO Abbreviation: Arthritis Rheumatol Subsets: MEDLINE
Subject
Language
English
Abstract
Objective: To develop and validate new classification criteria for adult and juvenile idiopathic inflammatory myopathies (IIM) and their major subgroups.
Methods: Candidate variables were assembled from published criteria and expert opinion using consensus methodology. Data were collected from 47 rheumatology, dermatology, neurology, and pediatric clinics worldwide. Several statistical methods were utilized to derive the classification criteria.
Results: Based on data from 976 IIM patients (74% adults; 26% children) and 624 non-IIM patients with mimicking conditions (82% adults; 18% children), new criteria were derived. Each item is assigned a weighted score. The total score corresponds to a probability of having IIM. Subclassification is performed using a classification tree. A probability cutoff of 55%, corresponding to a score of 5.5 (6.7 with muscle biopsy) "probable IIM," had best sensitivity/specificity (87%/82% without biopsies, 93%/88% with biopsies) and is recommended as a minimum to classify a patient as having IIM. A probability of ≥90%, corresponding to a score of ≥7.5 (≥8.7 with muscle biopsy), corresponds to "definite IIM." A probability of <50%, corresponding to a score of <5.3 (<6.5 with muscle biopsy), rules out IIM, leaving a probability of ≥50-<55% as "possible IIM."
Conclusion: The European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) classification criteria for IIM have been endorsed by international rheumatology, dermatology, neurology, and pediatric groups. They employ easily accessible and operationally defined elements, and have been partially validated. They allow classification of "definite," "probable," and "possible" IIM, in addition to the major subgroups of IIM, including juvenile IIM. They generally perform better than existing criteria.
(© 2017, American College of Rheumatology.)
Methods: Candidate variables were assembled from published criteria and expert opinion using consensus methodology. Data were collected from 47 rheumatology, dermatology, neurology, and pediatric clinics worldwide. Several statistical methods were utilized to derive the classification criteria.
Results: Based on data from 976 IIM patients (74% adults; 26% children) and 624 non-IIM patients with mimicking conditions (82% adults; 18% children), new criteria were derived. Each item is assigned a weighted score. The total score corresponds to a probability of having IIM. Subclassification is performed using a classification tree. A probability cutoff of 55%, corresponding to a score of 5.5 (6.7 with muscle biopsy) "probable IIM," had best sensitivity/specificity (87%/82% without biopsies, 93%/88% with biopsies) and is recommended as a minimum to classify a patient as having IIM. A probability of ≥90%, corresponding to a score of ≥7.5 (≥8.7 with muscle biopsy), corresponds to "definite IIM." A probability of <50%, corresponding to a score of <5.3 (<6.5 with muscle biopsy), rules out IIM, leaving a probability of ≥50-<55% as "possible IIM."
Conclusion: The European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) classification criteria for IIM have been endorsed by international rheumatology, dermatology, neurology, and pediatric groups. They employ easily accessible and operationally defined elements, and have been partially validated. They allow classification of "definite," "probable," and "possible" IIM, in addition to the major subgroups of IIM, including juvenile IIM. They generally perform better than existing criteria.
(© 2017, American College of Rheumatology.)