期刊
ARTHRITIS & RHEUMATOLOGY
卷 69, 期 12, 页码 2271-2282出版社
WILEY
DOI: 10.1002/art.40320
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资金
- European League Against Rheumatism
- American College of Rheumatology
- Myositis Association
- NIH
- NIH (National Institute of Environmental Health Sciences)
- European Science Foundation for the Euromyositis Register
- Swedish Research Council [K2014-52X-14045-14-3]
- Stockholm County Council
- Karolinska Institutet
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH
- Arthritis Research UK [18474]
- Medical Research Council [MR/N003322/1]
- Ministry of Health, Czech Republic [00023728]
- MRC [MR/N003322/1, MR/P020941/1] Funding Source: UKRI
- Medical Research Council [MR/N003322/1, MR/P020941/1] Funding Source: researchfish
- National Institute for Health Research [CL-2006-06-010] Funding Source: researchfish
- ReumaFonds [LLP-10] Funding Source: researchfish
- Versus Arthritis [18474] Funding Source: researchfish
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.
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