EULAR/ACR classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups: A methodology report

International Myositis Classification Criteria Project consortium, the Euromyositis register and the Juvenile Dermatomyositis Cohort Biomarker Study and Repository (JDRG) (UK and Ireland)

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Resumen

Objective T o describe the methodology used to develop new classification criteria for adult and juvenile idiopathic inflammatory myopathies (IIMs) and their major subgroups. Methods A n 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-ofitems approach criteria and (3) a classification-tree approach. Results T he approaches yielded several candidate models that were scrutinised with respect to statistical performance and clinical relevance. The probabilityscore 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.

Idioma originalEnglish
Número de artículoe000507
PublicaciónRMD Open
Volumen3
N.º2
DOI
EstadoPublished - 2017

Nota bibliográfica

Funding Information:
This study was financially supported by ACR, EULAR, The Myositis Association (TMA), the Intramural Research Program of the NIH, National Institute of Environmental Health Sciences and the European Science Foundation for the Euromyositis Register. CARRA, Inc. is funded by NIH-NIAMS, Friends of CARRA and the Arthritis Foundation.

Funding Information:
Competing interests JaS has received research grants from takeda and Savient and consultant fees from Savient, takeda, regeneron, Merz, Bioiberica, crealta and allergan. JaS serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DinOra, inc., a 501 (c)(3) entity. JaS is a member of the executive of OMeract, an organisation that develops outcome measures in rheumatology and receives arms-length funding from 36 companies; a member of the american college of rheumatology’s (acr) annual Meeting Planning committee (aMPc); chair of the acr Meet-the-Professor, Workshop and Study group Subcommittee; and a member of the Veterans affairs rheumatology Field advisory committee. Hc and rgc’s work in myositis is partly funded by grants from arthritis research UK (18474) and the Medical research council (Mr/n003322/1). JV’s work in myositis is supported by the Project (Ministry of Health, czech republic) for conceptual Development of research Organization 00023728.

Funding Information:
Funding this study was financially supported by acr, eUlar, the Myositis association (tMa), the intramural research Program of the niH, national institute of environmental Health Sciences and the european Science Foundation for the euromyositis register. carra, inc. is funded by niH-niaMS, Friends of carra and the arthritis Foundation.

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.

ASJC Scopus Subject Areas

  • Immunology and Allergy
  • Rheumatology
  • Immunology

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