The 2023 ACR/EULAR classification criteria for calcium pyrophosphate deposition disease.
The 2023 ACR/EULAR classification criteria for calcium pyrophosphate deposition disease.
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DOI：
10.1136/ard-2023-224575
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发表时间：
2023-10
影响因子：
27.4
通讯作者：
中科院分区：
文献类型：
--
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焦磷酸钙沉积（CPPD）疾病是普遍存在的，并有不同的表现，但没有这种症状性关节炎的分类标准。我们开发了第一个有效的症状性CPPD疾病的分类标准。在美国流变学学会（ACR）和欧洲流变学协会联盟（EULAR）的支持下，一个由多国研究人员组成的小组遵循既定的方法来制定这些标准。我们生成了候选项列表并完善了其定义，收集了去识别的患者资料，评估了候选项与CPPD疾病之间的关联强度，开发了分类标准框架，并使用多标准决策分析来定义标准权重和分类阈值得分。我们在一个独立的队列中验证了该标准。在外周或轴向关节疼痛、肿胀或压痛（入选标准）且其他疾病不能完全解释其症状（排除标准）的患者中，滑液中存在冠状齿综合征或CPP晶体足以归类为CPPD疾病。在没有这些发现的情况下，使用由临床特征、相关代谢紊乱以及实验室和成像检查结果组成的加权标准，得分>56分可用于将其归类为CPPD疾病。这些标准在推导队列（190个CPPD病例，148个模拟者）中的灵敏度为92.2%，特异性为87.9%，而在验证队列（251个CPPD病例，162个模拟者）中的灵敏度为99.2%，特异性为92.5%。第一个ACR/EULAR CPPD疾病分类标准具有优异的性能特征，将促进该领域的研究。
Calcium pyrophosphate deposition (CPPD) disease is prevalent and has diverse presentations, but there are no classification criteria for this symptomatic arthritis. We developed the first ever validated classification criteria for symptomatic CPPD disease. Supported by the American College of Rheumatology (ACR) and the European Alliance of Associations for Rheumatology (EULAR), a multinational group of investigators followed established methodology to develop these criteria. We generated lists of candidate items and refined their definitions, collected de-identified patient profiles, evaluated strengths of associations between candidate items and CPPD disease, developed a classification criteria framework, and used multi-criterion decision analysis to define criteria weights and a classification threshold score. We validated the criteria in an independent cohort. Among patients with pain, swelling or tenderness at a peripheral or axial joint(entry criterion) whose symptoms are not fully explained by an alternative disease (exclusion criterion), the presence of crowned dens syndrome or CPP crystals in synovial fluid are sufficient to classify as CPPD disease. In the absence of these findings, a score >56 points using weighted criteria comprised of clinical features, associated metabolic disorders, and results of laboratory and imaging investigations can be used to classify as CPPD disease. These criteria had a sensitivity of 92.2% and specificity of 87.9% in the derivation cohort (190 CPPD cases, 148 mimickers), whereas sensitivity was 99.2% and specificity was 92.5% in the validation cohort (251 CPPD cases, 162 mimickers). The first ACR/EULAR CPPD disease classification criteria have excellent performance characteristics and will facilitate research in this field.
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影响因子：
5.5
作者：
Cipolletta, Edoardo;Filippucci, Emilio;Di Matteo, Andrea
通讯作者：
Di Matteo, Andrea
影响因子：
7.2
作者：
Johnson, Sindhu R.;Naden, Raymond P.;Khanna, Dinesh
通讯作者：
Khanna, Dinesh
影响因子：
27.4
作者：
Zhang, W.;Doherty, M.;Pascual, E.
通讯作者：
Pascual, E.
影响因子：
7
作者：
Lee, K. -A.;Lee, S. -H.;Kim, H. -R.
通讯作者：
Kim, H. -R.
影响因子：
13.3
作者：
Aringer, Martin;Costenbader, Karen;Johnson, Sindhu R.
通讯作者：
Johnson, Sindhu R.