Journal article
Authors list: van den Hoogen, Frank; Khanna, Dinesh; Fransen, Jaap; Johnson, Sindhu R.; Baron, Murray; Tyndall, Alan; Matucci-Cerinic, Marco; Naden, Raymond P.; Medsger, Thomas A., Jr.; Carreira, Patricia E.; Riemekasten, Gabriela; Clements, Philip J.; Denton, Christopher P.; Distler, Oliver; Allanore, Yannick; Furst, Daniel E.; Gabrielli, Armando; Mayes, Maureen D.; van Laar, Jacob M.; Seibold, James R.; Czirjak, Laszlo; Steen, Virginia D.; Inanc, Murat; Kowal-Bielecka, Otylia; Mueller-Ladner, Ulf; Valentini, Gabriele; Veale, Douglas J.; Vonk, Madelon C.; Walker, Ulrich A.; Chung, Lorinda; Collier, David H.; Csuka, Mary Ellen; Fessler, Barri J.; Guiducci, Serena; Herrick, Ariane; Hsu, Vivien M.; Jimenez, Sergio; Kahaleh, Bashar; Merkel, Peter A.; Sierakowski, Stanislav; Silver, Richard M.; Simms, Robert W.; Varga, John; Pope, Janet E.
Publication year: 2013
Pages: 1747-1755
Journal: Annals of the Rheumatic Diseases
Volume number: 72
Issue number: 11
ISSN: 0003-4967
eISSN: 1468-2060
DOI Link: https://doi.org/10.1136/annrheumdis-2013-204424
Publisher: Elsevier
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, seven 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. Conclusions 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.
Abstract:
Citation Styles
Harvard Citation style: van den Hoogen, F., Khanna, D., Fransen, J., Johnson, S., Baron, M., Tyndall, A., et al. (2013) 2013 classification criteria for systemic sclerosis: an American college of rheumatology/European league against rheumatism collaborative initiative, Annals of the Rheumatic Diseases, 72(11), pp. 1747-1755. https://doi.org/10.1136/annrheumdis-2013-204424
APA Citation style: van den Hoogen, F., Khanna, D., Fransen, J., Johnson, S., Baron, M., Tyndall, A., Matucci-Cerinic, M., Naden, R., Medsger, T., Carreira, P., Riemekasten, G., Clements, P., Denton, C., Distler, O., Allanore, Y., Furst, D., Gabrielli, A., Mayes, M., van Laar, J., ...Pope, J. (2013). 2013 classification criteria for systemic sclerosis: an American college of rheumatology/European league against rheumatism collaborative initiative. Annals of the Rheumatic Diseases. 72(11), 1747-1755. https://doi.org/10.1136/annrheumdis-2013-204424
Keywords
AUTOANTIBODIES; CAPILLARY MICROSCOPY; disease activity; Systemic sclerosis
