TY - JOUR
T1 - 2017 European League Against Rheumatism/American College of Rheumatology classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups
AU - International Myositis Classification Criteria Project consortium, the Euromyositis register and the Juvenile Dermatomyositis Cohort Biomarker Study and Repository (JDRG) (UK and Ireland)
AU - Lundberg, Ingrid E.
AU - Tjärnlund, Anna
AU - Bottai, Matteo
AU - Werth, Victoria P.
AU - Pilkington, Clarissa
AU - Visser, Marianne de
AU - Alfredsson, Lars
AU - Amato, Anthony A.
AU - Barohn, Richard J.
AU - Liang, Matthew H.
AU - Singh, Jasvinder A.
AU - Aggarwal, Rohit
AU - Arnardottir, Snjolaug
AU - Chinoy, Hector
AU - Cooper, Robert G.
AU - Dankó, Katalin
AU - Dimachkie, Mazen M.
AU - Feldman, Brian M.
AU - Torre, Ignacio Garcia De La
AU - Gordon, Patrick
AU - Hayashi, Taichi
AU - Katz, James D.
AU - Kohsaka, Hitoshi
AU - Lachenbruch, Peter A.
AU - Lang, Bianca A.
AU - Li, Yuhui
AU - Oddis, Chester V.
AU - Olesinska, Marzena
AU - Reed, Ann M.
AU - Rutkowska-Sak, Lidia
AU - Sanner, Helga
AU - Selva-O'Callaghan, Albert
AU - Song, Yeong Wook
AU - Vencovsky, Jiri
AU - Ytterberg, Steven R.
AU - Miller, Frederick W.
AU - Rider, Lisa G.
N1 - Publisher Copyright:
© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
PY - 2017/12/1
Y1 - 2017/12/1
N2 - 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 paediatric clinics worldwide. Several statistical methods were used 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 cut-off 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 to <55% as 'possible IIM'.CONCLUSIONS: The European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) classification criteria for IIM have been endorsed by international rheumatology, dermatology, neurology and paediatric 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.
AB - 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 paediatric clinics worldwide. Several statistical methods were used 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 cut-off 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 to <55% as 'possible IIM'.CONCLUSIONS: The European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) classification criteria for IIM have been endorsed by international rheumatology, dermatology, neurology and paediatric 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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U2 - 10.1136/annrheumdis-2017-211468
DO - 10.1136/annrheumdis-2017-211468
M3 - Article
C2 - 29079590
AN - SCOPUS:85037677819
SN - 0003-4967
VL - 76
SP - 1955
EP - 1964
JO - Annals of the Rheumatic Diseases
JF - Annals of the Rheumatic Diseases
IS - 12
ER -