2013 Classification Criteria for Systemic Sclerosis An American College of Rheumatology/European League Against Rheumatism Collaborative Initiative

被引：1445

作者：

van den Hoogen, Frank ^{[1
,2
]}

Khanna, Dinesh ^{[3
]}

Fransen, Jaap ^{[2
]}

Johnson, Sindhu R. ^{[4
,5
]}

Baron, Murray ^{[6
,7
]}

Tyndall, Alan ^{[8
,9
]}

Matucci-Cerinic, Marco ^{[10
]}

Naden, Raymond P. ^{[11
,12
]}

Medsger, Thomas A., Jr. ^{[13
]}

Carreira, Patricia E. ^{[14
]}

Riemekasten, Gabriela ^{[15
,16
]}

Clements, Philip J. ^{[17
]}

Denton, Christopher P. ^{[18
,19
]}

Distler, Oliver ^{[20
]}

Allanore, Yannick ^{[21
,22
]}

Furst, Daniel E. ^{[17
]}

Gabrielli, Armando ^{[23
]}

Mayes, Maureen D. ^{[24
]}

van Laar, Jacob M. ^{[25
]}

Seibold, James R. ^{[26
]}

Czirjak, Laszlo ^{[27
]}

Steen, Virginia D. ^{[28
]}

Inanc, Murat ^{[29
]}

Kowal-Bielecka, Otylia ^{[30
]}

Mueller-Ladner, Ulf ^{[31
,32
]}

Valentini, Gabriele ^{[33
]}

Veale, Douglas J. ^{[34
]}

Vonk, Madelon C. ^{[2
]}

Walker, Ulrich A. ^{[8
,9
]}

Chung, Lorinda ^{[35
]}

Collier, David H. ^{[36
,37
]}

Csuka, Mary Ellen ^{[38
]}

Fessler, Barri J. ^{[39
]}

Guiducci, Serena ^{[10
]}

Herrick, Ariane ^{[40
,41
]}

Hsu, Vivien M. ^{[42
]}

Jimenez, Sergio ^{[43
]}

Kahaleh, Bashar ^{[44
]}

Merkel, Peter A. ^{[45
]}

Sierakowski, Stanislav ^{[30
]}

Silver, Richard M. ^{[46
]}

Simms, Robert W. ^{[45
]}

Varga, John ^{[47
]}

Pope, Janet E. ^{[48
,49
]}

机构：

[1] St Maartens Clin, NL-6500 GM Nijmegen, Netherlands

[2] Radboud Univ Nijmegen, Med Ctr, NL-6525 ED Nijmegen, Netherlands

[3] Univ Michigan, Ann Arbor, MI 48109 USA

[4] Mt Sinai Hosp, Toronto Western Hosp, Toronto, ON M5G 1X5, Canada

[5] Univ Toronto, Toronto, ON, Canada

[6] McGill Univ, Jewish Gen Hosp, Montreal, PQ H3T 1E2, Canada

[7] McGill Univ, Montreal, PQ, Canada

[8] Felix Platter Hosp, Basel, Switzerland

[9] Univ Basel, Basel, Switzerland

[10] Univ Florence, Florence, Italy

[11] Auckland City Hosp, Auckland, New Zealand

[12] New Zealand Hlth Minist, Auckland, New Zealand

[13] Univ Pittsburgh, Sch Med, Pittsburgh, PA USA

[14] Hosp Univ 12 Octubre, Madrid, Spain

[15] Charite, German Rheumatol Res Ctr, D-13353 Berlin, Germany

[16] Leibniz Inst, Berlin, Germany

[17] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA

[18] Royal Free Hosp, London NW3 2QG, England

[19] UCL, Sch Med, London W1N 8AA, England

[20] Univ Zurich Hosp, CH-8091 Zurich, Switzerland

[21] Univ Paris 05, Paris, France

[22] Hop Cochin, AP HP, F-75674 Paris, France

[23] Clin Med Univ Politecn Marche, Ancona, Italy

[24] Univ Texas Hlth Sci Ctr Houston, Houston, TX USA

[25] Newcastle Univ, Sch Med, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England

[26] Scleroderma Res Consultants, Avon, CT USA

[27] Univ Pecs, Med Ctr, Pecs, Hungary

[28] Georgetown Univ, Sch Med, Washington, DC USA

[29] Istanbul Univ, Istanbul, Turkey

[30] Med Univ Bialystok, Bialystok, Poland

[31] Univ Giessen, Bad Nauheim, Germany

[32] Kerckhoff Clin, Bad Nauheim, Germany

[33] Univ Naples 2, Naples, Italy

[34] St Vincents Univ Hosp, Dublin 4, Ireland

[35] Stanford Univ, Sch Med, Stanford, CA 94305 USA

[36] Univ Colorado, Sch Med, Denver, CO USA

[37] Denver Hlth Med Ctr, Denver, CO USA

[38] Med Coll Wisconsin, Milwaukee, WI 53226 USA

[39] Univ Alabama Birmingham, Birmingham, AL USA

[40] Univ Manchester, Manchester, Lancs, England

[41] Salford Royal Natl Hlth Serv Fdn Trust, Salford, Lancs, England

[42] Rutgers Robert Wood Johnson Med Sch, New Brunswick, NJ USA

[43] Thomas Jefferson Univ, Philadelphia, PA 19107 USA

[44] Univ Toledo, Toledo, OH 43606 USA

[45] Boston Univ, Sch Med, Boston, MA 02118 USA

[46] Med Univ S Carolina, Charleston, SC USA

[47] Northwestern Univ, Feinberg Sch Med, Chicago, IL 60611 USA

[48] St Josephs Hlth Care London, London, ON, Canada

[49] Univ Western Ontario, London, ON, Canada

来源：

ARTHRITIS AND RHEUMATISM | 2013年 / 65卷 / 11期

基金：

加拿大健康研究院;

关键词：

CAPILLARY MICROSCOPY; AUTOANTIBODIES; SENSITIVITY; VALIDATION;

D O I：

10.1002/art.38098

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

ObjectiveThe 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. MethodsUsing 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. ResultsIt 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, 7 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. ConclusionThe 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.

引用

页码：2737 / 2747

页数：11

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