Items for developing revised classification criteria in systemic sclerosis: Results of a consensus exercise
Items for developing revised classification criteria in systemic sclerosis: Results of a consensus exercise
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DOI：
10.1002/acr.20679
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发表时间：
2012-03-01
影响因子：
4.7
通讯作者：
Khanna, Dinesh
中科院分区：
文献类型：
--
作者：
Fransen, Jaap;Johnson, Sindhu R.;Khanna, Dinesh
目的 系统性硬化症（SSc；硬皮病）的分类标准正在更新。我们的目标是使用共识程序（包括 Delphi 和名义组技术 (NGT)）选择一组可能对 SSc 分类有用的项目。方法。这些项目是通过硬皮病临床试验联盟和欧洲抗风湿病联盟硬皮病试验和研究小组进行的两次独立共识练习确定的。对两次演习的第一轮项目进行了整理，删除了多余的项目，留下了 168 个项目。使用 1-9 等级（其中 1 = 完全不合适，9 = 完全合适）进行 3 轮 Delphi 练习，并使用 NGT 召开共识会议。在德尔福最后一轮中，项目按 1-10 等级进行排名。结果。在第一轮中，106位专家对168个项目进行了评分。那些中位数分数 < 4 的项目被删除，从而得到 102 个项目的列表。在第 2 轮中，再次对这些项目进行适当性评级，并由欧洲和北美 SSc 专家（n = 16）使用 NGT 进行共识会议，最终产生 23 个项目。在第 3 轮中，SSc 专家 (n = 26) 使用适当性分数 (1-9) 对最后一轮 Delphi 中的 23 个项目中的每一个进行单独评分，并对 10 个最适合 SSc 分类的项目进行排名。皮肤增厚、SSc 特异性自身抗体、异常甲襞毛细血管模式和雷诺现象在最终列表中排名最高，其中还包括表明内脏器官受累的项目。结论。 Delphi 练习和 NGT 得出了一组 23 个 SSc 分类项目，将在前瞻性研究中评估其区分特性。
Objective Classification criteria for systemic sclerosis (SSc; scleroderma) are being updated. Our objective was to select a set of items potentially useful for the classification of SSc using consensus procedures, including the Delphi and nominal group techniques (NGT).Methods. Items were identified through 2 independent consensus exercises performed by the Scleroderma Clinical Trials Consortium and the European League Against Rheumatism Scleroderma Trials and Research Group. The first-round items from both exercises were collated and redundancies were removed, leaving 168 items. A 3-round Delphi exercise was performed using a 1-9 scale (where 1 = completely inappropriate and 9 = completely appropriate) and a consensus meeting using NGT was conducted. During the last Delphi round, the items were ranked on a 1-10 scale.Results. In round 1, 106 experts rated the 168 items. Those with a median score of < 4 were removed, resulting in a list of 102 items. In round 2, the items were again rated for appropriateness and subjected to a consensus meeting using NGT by European and North American SSc experts (n = 16), resulting in 23 items. In round 3, SSc experts (n = 26) then individually scored each of the 23 items in a last Delphi round using an appropriateness score (1-9) and ranking their 10 most appropriate items for the classification of SSc. Presence of skin thickening, SSc-specific autoantibodies, abnormal nailfold capillary pattern, and Raynaud's phenomenon ranked highest in the final list that also included items indicating internal organ involvement.Conclusion. The Delphi exercise and NGT resulted in a set of 23 items for the classification of SSc that will be assessed for their discriminative properties in a prospective study.