Validation of potential classification criteria for systemic sclerosis
Validation of potential classification criteria for systemic sclerosis
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DOI：
10.1002/acr.20684
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发表时间：
2012-03-01
影响因子：
4.7
通讯作者：
Pope, Janet E.
中科院分区：
文献类型：
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作者：
Johnson, Sindhu R.;Fransen, Jaap;Pope, Janet E.
目的美国风湿病学会和欧洲风湿病联盟正在联合更新系统性硬化症(SSC)的分类标准。使用Delphi和名义分组技术将潜在的分类项目减少到23个。我们评估了有待进一步研究的条目的面子效度、判别效度和结构效度，作为潜在标准。面孔有效性是使用从加拿大硬皮病研究小组、狼疮1000张脸以及匹兹堡、多伦多、马德里和柏林结缔组织病(CTD)数据库中抽样的患者中的项目频率来评估的。将783例SSc患者与1071例与SSC相似的疾病患者(模拟者)进行比较：系统性红斑狼疮499例，肌炎171例，SJO“gren‘s综合征95例，雷诺现象228例，混合性CTD 29例，特发性肺动脉高压49例。用优势比(ORs)评价判别效度。在结构效度方面，对经验性排名和专家排名进行了比较。与模仿者相比，皮肤增厚(OR 427)、毛细血管扩张(OR 91)、抗RNA聚合酶III抗体(OR 75)、手指浮肿(OR 35)、手指屈曲痉挛(OR 29)、肌腱/法氏囊摩擦摩擦(OR 27)、抗拓扑异构酶I抗体(OR 25)、RP(OR 24)、指尖溃疡/凹陷性瘢痕(OR 19)、抗球内翻抗体(OR 14)、甲皱毛细血管异常(OR 10)、胃食道反流病症状(OR 8)、抗核抗体、钙化、吞咽困难和食道扩张(OR均为6)；间质性肺疾病/肺纤维化(OR5)；抗PM-SCL抗体(OR2)。一氧化碳弥散量、PAH减少和用力肺活量减少的相对危险度为2.肾危象和指髓丢失/顶骨溶解未发生在SSC模拟器中(或未估计)。经验性排名与专家排名相关(Spearman‘s==0.53，P=0.01)。候选条目具有较好的表现力、区分度和结构效度。在未来的SSC和MIMICKER案例中，将评估进一步的项目减少。
Objective Classification criteria for systemic sclerosis (SSc; scleroderma) are being updated jointly by the American College of Rheumatology and European League Against Rheumatism. Potential items for classification were reduced to 23 using Delphi and nominal group techniques. We evaluated the face, discriminant, and construct validity of the items to be further studied as potential criteria.Methods. Face validity was evaluated using the frequency of items in patients sampled from the Canadian Scleroderma Research Group, 1000 Faces of Lupus, and the Pittsburgh, Toronto, Madrid, and Berlin connective tissue disease (CTD) databases. Patients with SSc (n = 783) were compared to 1,071 patients with diseases similar to SSc (mimickers): systemic lupus erythematosus (n = 499), myositis (n = 171), Sjo " gren's syndrome (n = 95), Raynaud's phenomenon (RP; n = 228), mixed CTD (n = 29), and idiopathic pulmonary arterial hypertension (PAH; n = 49). Discriminant validity was evaluated using odds ratios (ORs). For construct validity, empirical ranking was compared to expert ranking.Results. Compared to mimickers, patients with SSc were more likely to have skin thickening (OR 427); telangiectasias (OR 91); anti- RNA polymerase III antibody (OR 75); puffy fingers (OR 35); finger flexion contractures (OR 29); tendon/ bursal friction rubs (OR 27); anti- topoisomerase I antibody (OR 25); RP (OR 24); fingertip ulcers/ pitting scars (OR 19); anticentromere antibody (OR 14); abnormal nailfold capillaries (OR 10); gastroesophageal reflux disease symptoms (OR 8); antinuclear antibody, calcinosis, dysphagia, and esophageal dilation (all OR 6); interstitial lung disease/ pulmonary fibrosis (OR 5); and anti- PM- Scl antibody (OR 2). Reduced carbon monoxide diffusing capacity, PAH, and reduced forced vital capacity had ORs of < 2. Renal crisis and digital pulp loss/ acroosteolysis did not occur in SSc mimickers (OR not estimated). Empirical and expert ranking were correlated (Spearman's = = 0.53, P = 0.01).Conclusion. The candidate items have good face, discriminant, and construct validity. Further item reduction will be evaluated in prospective SSc and mimicker cases.