EULAR/ACR classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups: a methodology report.
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Bottai Matteo, Tjärnlund Anna, Santoni Giola, Werth Victoria P, Pilkington Clarissa, de Visser Marianne, Alfredsson Lars, Amato Anthony A, Barohn Richard J, Liang Matthew H, Singh Jasvinder A, Aggarwal Rohit, Arnardottir Snjolaug, Chinoy Hector, Cooper Robert G, Danko Katalin, Dimachkie Mazen M, Feldman Brian M, García-De La Torre Ignacio, Gordon Patrick, Hayashi Taichi, Katz James D, Kohsaka Hitoshi, Lachenbruch Peter A, Lang Bianca A, Li Yuhui, Oddis Chester V, Olesinka Marzena, Reed Ann M, Rutkowska-Sak Lidia, Sanner Helga, Selva-O'Callaghan Albert, Wook Song Yeong, Vencovsky Jiri, Ytterberg Steven R, Miller Frederick W, Rider Lisa G, Lundberg Ingrid E, International Myositis Classification Criteria Project consortium, the Euromyositis register and the Juvenile Dermatomyositis Cohort Biomarker Study and Repository (JDRG) (UK and Ireland)
Аннотация
METHODS: An international, multidisciplinary group of myositis experts produced a set of 93 potentially relevant variables to be tested for inclusion in the criteria. Rheumatology, dermatology, neurology and paediatric clinics worldwide collected data on 976 IIM cases (74% adults, 26% children) and 624 non-IIM comparator cases with mimicking conditions (82% adults, 18% children). The participating clinicians classified each case as IIM or non-IIM. Generally, the classification of any given patient was based on few variables, leaving remaining variables unmeasured. We investigated the strength of the association between all variables and between these and the disease status as determined by the physician. We considered three approaches: (1) a probability-score approach, (2) a sum-of-items approach criteria and (3) a classification-tree approach.
RESULTS: The approaches yielded several candidate models that were scrutinised with respect to statistical performance and clinical relevance. The probability-score approach showed superior statistical performance and clinical practicability and was therefore preferred over the others. We developed a classification tree for subclassification of patients with IIM. A calculator for electronic devices, such as computers and smartphones, facilitates the use of the European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) classification criteria.
CONCLUSIONS: The new EULAR/ACR classification criteria provide a patient's probability of having IIM for use in clinical and research settings. The probability is based on a score obtained by summing the weights associated with a set of criteria items.