Can SLE classification rules be effectively applied to diagnose unclear SLE cases?
Can SLE classification rules be effectively applied to diagnose unclear SLE cases?
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DOI：
10.1177/0961203316655212
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发表时间：
2017-02
期刊：
影响因子：
2.6
通讯作者：
Mills DK
中科院分区：
文献类型：
--
作者：
Mesa A;Fernandez M;Wu W;Narasimhan G;Greidinger EL;Mills DK
制定一个新的分类标准来区分不明确的SLE和MCTD病例。研究评估了来自111例SLE和55例MCTD患者的205个变量，以发现每种疾病的独特分子和临床标志物。对目前使用的SLE和MCTD分类标准集进行二项logistic回归（BLR），得到6个具有区分不明确SLE和MCTD患者能力的简化模型，并由接收工作特征（ROC）曲线证实。决策树被用来描述新的分类规则来区分不明确的SLE和MCTD患者。SLE和MCTD患者表现出不同的分子标志物和临床表现。此外，简化模型强调SLE患者表现出皮疹和肾脏疾病的患病率，而MCTD病例表现出肌炎和肌肉无力的优势。此外，决策树分析揭示了一种新的分类规则，用于区分不明确的SLE和MCTD患者（Lu-vs-M），总体准确率为88%。我们提出的新分类规则（Lu-vs-M）的验证包括SLE和MCTD患者之间的新对比特征（钙化，CPK升高以及U1-70K， U1A和U1C的抗igm反应性），与目前使用的分类标准集相比，在区分这些疾病方面显示出33%的改善。在进一步的验证中，我们的新分类规则是一种很有希望的方法来区分诊断不明确的SLE和MCTD患者。
Develop a novel classification criteria to distinguish between unclear SLE and MCTD cases. A total of 205 variables from 111 SLE and 55 MCTD patients were evaluated to uncover unique molecular and clinical markers for each disease. Binomial logistic regressions (BLR) were performed on currently used SLE and MCTD classification criteria sets to obtain six reduced models with power to discriminate between unclear SLE and MCTD patients which were confirmed by Receiving Operating Characteristic (ROC) curve. Decision trees were employed to delineate novel classification rules to discriminate between unclear SLE and MCTD patients. SLE and MCTD patients exhibited contrasting molecular markers and clinical manifestations. Furthermore, reduced models highlighted SLE patients exhibit prevalence of skin rashes and renal disease while MCTD cases show dominance of myositis and muscle weakness. Additionally decision trees analyses revealed a novel classification rule tailored to differentiate unclear SLE and MCTD patients (Lu-vs-M) with an overall accuracy of 88%. Validation of our novel proposed classification rule (Lu-vs-M) includes novel contrasting characteristics (calcinosis, CPK elevated and anti-IgM reactivity for U1-70K, U1A and U1C) between SLE and MCTD patients and showed a 33% improvement in distinguishing these disorders when compare to currently used classification criteria sets. Pending additional validation, our novel classification rule is a promising method to distinguish between patients with unclear SLE and MCTD diagnosis.
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影响因子：
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作者：
Petri, Michelle;Orbai, Ana-Maria;Alarcon, Graciela S.;Gordon, Caroline;Merrill, Joan T.;Fortin, Paul R.;Bruce, Ian N.;Isenberg, David;Wallace, Daniel J.;Nived, Ola;Sturfelt, Gunnar;Ramsey-Goldman, Rosalind;Bae, Sang-Cheol;Hanly, John G.;Sanchez-Guerrero, Jorge;Clarke, Ann;Aranow, Cynthia;Manzi, Susan;Urowitz, Murray;Gladman, Dafna;Kalunian, Kenneth;Costner, Melissa;Werth, Victoria P.;Zoma, Asad;Bernatsky, Sasha;Ruiz-Irastorza, Guillermo;Khamashta, Munther A.;Jacobsen, Soren;Buyon, Jill P.;Maddison, Peter;Dooley, Mary Anne;van vollenhoven, Ronald F.;Ginzler, Ellen;Stoll, Thomas;Peschken, Christine;Jorizzo, Joseph L.;Callen, Jeffrey P.;Lim, S. Sam;Fessler, Barri J.;Inanc, Murat;Kamen, Diane L.;Rahman, Anisur;Steinsson, Kristjan;Franks, Andrew G., Jr.;Sigler, Lisa;Hameed, Suhail;Fang, Hong;Ngoc Pham;Brey, Robin;Weisman, Michael H.;McGwin, Gerald, Jr.;Magder, Laurence S.
通讯作者：
Magder, Laurence S.
影响因子：
5.5
作者：
Gunnarsson, Ragnar;Andreassen, Arne K.;Gran, Jan Tore
通讯作者：
Gran, Jan Tore
影响因子：
2.3
作者：
Aringer, M;Steiner, G;Smolen, JS
通讯作者：
Smolen, JS
影响因子：
2.6
作者：
Nowicka-Sauer, K.;Czuszynska, Z.;Siebert, J.
通讯作者：
Siebert, J.
影响因子：
1.2
作者：
Watanabe, Yasutaka;Koyama, Shinichiro;Kawabata, Yoshinori
通讯作者：
Kawabata, Yoshinori