2017 European League Against Rheumatism/American College of Rheumatology classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups

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Lundberg, Ingrid E, Tjarnlund, Anna, Bottai, Matteo, Werth, Victoria P, Pilkington, Clarissa, de Visser, Marianne, Alfredsson, Lars, Amato, Anthony A, Barohn, Richard J, Liang, Matthew H et al (show 27 more authors) , Singh, Jasvinder A, Aggarwal, Rohit, Arnardottir, Snjolaug, Chinoy, Hector, Cooper, Robert G ORCID: 0000-0001-8337-9973, Danko, Katalin, Dimachkie, Mazen M, Feldman, Brian M, Garcia-De La Torre, Ignacio, Gordon, Patrick, Hayashi, Taichi, Katz, James D, Kohsaka, Hitoshi, Lachenbruch, Peter A, Lang, Bianca A, Li, Yuhui, Oddis, Chester V, Olesinska, Marzena, Reed, Ann M, Rutkowska-Sak, Lidia, Sanner, Helga, Selva-O'Callaghan, Albert, Song, Yeong-Wook, Vencovsky, Jiri, Ytterberg, Steven R, Miller, Frederick W and Rider, Lisa G (2017) 2017 European League Against Rheumatism/American College of Rheumatology classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups. ANNALS OF THE RHEUMATIC DISEASES, 76 (12). pp. 1955-1964.

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Abstract

<h4>Objective</h4>To develop and validate new classification criteria for adult and juvenile idiopathic inflammatory myopathies (IIM) and their major subgroups.<h4>Methods</h4>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.<h4>Results</h4>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'.<h4>Conclusions</h4>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.

Item Type:	Article
Uncontrolled Keywords:	International Myositis Classification Criteria Project consortium, The Euromyositis register and The Juvenile Dermatomyositis Cohort Biomarker Study and Repository (JDRG) (UK and Ireland), Muscle, Skeletal, Humans, Myositis, Diagnosis, Differential, Biopsy, Probability, Sensitivity and Specificity, Consensus, Rheumatology, Reference Values, Adult, Child, Societies, Medical, United States, Europe
Depositing User:	Symplectic Admin
Date Deposited:	27 Nov 2017 10:56
Last Modified:	19 Jan 2023 06:50
DOI:	10.1136/annrheumdis-2017-211468
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3011622