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2017 European League Against Rheumatism/American College of Rheumatology Classification Criteria for Adult and Juvenile Idiopathic Inflammatory Myopathies and Their Major Subgroups
Author(s) -
Lundberg Ingrid E.,
Tjärnlund Anna,
Bottai Matteo,
Werth Victoria P.,
Pilkington Clarissa,
Visser Marianne,
Alfredsson Lars,
Amato Anthony A.,
Barohn Richard J.,
Liang Matthew H.,
Singh Jasvinder A.,
Aggarwal Rohit,
Arnardottir Snjolaug,
Chinoy Hector,
Cooper Robert G.,
Dankó Katalin,
Dimachkie Mazen M.,
Feldman Brian M.,
GarciaDe 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.,
RutkowskaSak Lidia,
Sanner Helga,
SelvaO'Callaghan Albert,
Song YeongWook,
Vencovsky Jiri,
Ytterberg Steven R.,
Miller Frederick W.,
Rider Lisa G.
Publication year - 2017
Publication title -
arthritis and rheumatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.106
H-Index - 314
eISSN - 2326-5205
pISSN - 2326-5191
DOI - 10.1002/art.40320
Subject(s) - rheumatology , rheumatism , medicine , neurology , juvenile dermatomyositis , biopsy , physical therapy , dermatology , dermatomyositis , psychiatry
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 pediatric clinics worldwide. Several statistical methods were utilized 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 cutoff 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–<55% as “possible IIM.” Conclusion The European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) classification criteria for IIM have been endorsed by international rheumatology, dermatology, neurology, and pediatric 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.