The 2010 American College of Rheumatology/European League Against Rheumatism classification criteria for rheumatoid arthritis: Methodological Report Phase I
The 2010 American College of Rheumatology/European League Against Rheumatism classification criteria for rheumatoid arthritis: Methodological Report Phase I
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DOI：
10.1136/ard.2010.130310
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发表时间：
2010-09-01
影响因子：
27.4
通讯作者：
Silman, Alan
中科院分区：
文献类型：
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作者：
Funovits, Julia;Aletaha, Daniel;Silman, Alan
目的应用数据驱动的方法研究新出现的未分化炎性滑膜炎患者，关键变量，用于区分持续性或糜烂性疾病风险足够高的患者子集，以制定类风湿性关节炎（RA）的新标准方法在美国风湿病学会和欧洲反风湿联盟合作努力的第一阶段，RA的标准，由各自的研究者提供的早期关节炎队列的汇总分析。首先确定入组后第一年内与甲氨蝶呤治疗金标准相关的所有变量。主成分分析，然后用于确定显着的变量，这些集代表类似的领域。在最后一步中，从每个域中提取一个代表性变量，然后在多变量回归模型中测试所有这些变量的独立影响。根据最终模型中的OR，估计每个变量的相对权重。（及其相对重量）是：掌指关节肿胀（MCP; 1.5），近端指间关节肿胀（PIP; 1.5）、手腕肿胀（1.5）、手部压痛（即MCP、PIP或腕关节（2）），急性期反应（即，C反应蛋白或红细胞沉降率和体重中度或高度升高的任何一个（1为中度，高海拔2例））和血清学异常（即类风湿因子或抗瓜氨酸化蛋白抗体，同样对中度或高度分别加权（分别为2和4））。这在一份单独的方法学文件中报告，并用于推导最后一套标准。
Objective To apply a data-driven approach to investigate, in patients newly presenting with undifferentiated inflammatory synovitis, key variables that discriminate the subset of patients at sufficiently high risk of persistent or erosive disease for the purpose of developing new criteria for rheumatoid arthritis (RA).Methods In this first phase of the collaborative effort of the American College of Rheumatology and European League Against Rheumatism to develop new criteria for RA, a pooled analysis of early arthritis cohorts made available by the respective investigators is presented. All the variables associated with the gold standard of treatment with methotrexate during the first year after enrolment were first identified. Principal component analysis was then used to identify among the significant variables those sets that represent similar domains. In a final step, from each domain one representative variable was extracted, all of which were then tested for their independent effects in a multivariate regression model. From the OR in that final model, the relative weight of each variable was estimated.Results The final domains and variables identified by this process (and their relative weights) were: swelling of a metacarpophalangeal joint (MCP; 1.5), swelling of a proximal interphalangeal joint (PIP; 1.5), swelling of the wrist (1.5), tenderness of the hand (ie, MCP, PIP or wrist (2)), acute phase reaction (ie, C reactive protein or erythrocyte sedimentation rate and weights for moderate or high elevations of either one (1 for moderate, 2 for high elevation)) and serological abnormalities (ie, rheumatoid factors or anti-citrullinated protein antibodies, again with separate weights for moderate or high elevations (2 and 4, respectively)).Conclusion The results of this first phase were subsequently used in the second phase of the project, which is reported in a separate methodological paper, and for derivation of the final set of criteria.