Classifying idiopathic inflammatory myopathies: Comparing the performance of six existing criteria
Helen Linklater, Nicolò Pipitone, Michael R. Rose, Fiona Norwood, Richard Campbell, Carlo Salvarani, David L. Scott, Patrick Gordon
Arcispedale Santa Maria Nuova
Objective. Various criteria have been proposed to classify the inflammatory myositides (IIMs) polymyositis (PM) and dermatomyositis (DM). However, none have received universal acceptance. Our aim was to assess the performance of the main criteria used to classify IIM. Specialist consultant diagnosis was considered the gold standard. Methods. Patients attending King's College Hospital (KCH) or Reggio Emilia Hospital (REH) since 1990 with a diagnosis of IIM or non-inflammatory myopathy were identified, and their records and laboratory investigations retrospectively reviewed. Where the complete data required for the classification criteria or a final physician diagnosis was unavailable, patients were excluded. 52 patients with a specialist diagnosis of PM, DM, inclusion body myositis (IBM) or non-inflammatory myopathy were included. Agreement between specialist consultant diagnosis and classification criteria was measured using Cohen's kappa (?) statistics. Sensitivity and specificity were also calculated. Results. The Dalakas (2003) criteria demonstrated substantial agreement with specialist diagnosis: ?=0.69, sensitivity 77%, specificity 99%. The European Neuromuscular Centre criteria (ENMC) demonstrated fair agreement: ?=0.49, sensitivity 71%, specificity 82%. Other criteria performed less well. In particular, the Bohan and Peter criteria demonstrated a specificity of only 29%. Conclusions. The criteria of Dalakas (2003) agreed best with specialist consultant diagnosis. The criteria of Bohan and Peter demonstrated very poor specificity. Prospective studies are required to develop improved classification criteria.
Clinical and Experimental Rheumatology
Dermatomyositis
Inclusion body myositis
myositis
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Myositis Medicine & Life Sciences 100%
Consultants Medicine & Life Sciences 37%
Dermatomyositis Medicine & Life Sciences 28%
Sensitivity and Specificity Medicine & Life Sciences 26%
Muscular Diseases Medicine & Life Sciences 25%
Inclusion Body Myositis Medicine & Life Sciences 17%
Prospective Studies Medicine & Life Sciences 7%
Linklater, H., Pipitone, N., Rose, M. R., Norwood, F., Campbell, R., Salvarani, C., Scott, D. L., & Gordon, P. (2013). Classifying idiopathic inflammatory myopathies: Comparing the performance of six existing criteria. Clinical and Experimental Rheumatology, 31(5), 767-769.
Classifying idiopathic inflammatory myopathies : Comparing the performance of six existing criteria. / Linklater, Helen; Pipitone, Nicolò; Rose, Michael R.; Norwood, Fiona; Campbell, Richard; Salvarani, Carlo; Scott, David L.; Gordon, Patrick.
In: Clinical and Experimental Rheumatology, Vol. 31, No. 5, 2013, p. 767-769.
Linklater, H, Pipitone, N, Rose, MR, Norwood, F, Campbell, R, Salvarani, C, Scott, DL & Gordon, P 2013, 'Classifying idiopathic inflammatory myopathies: Comparing the performance of six existing criteria', Clinical and Experimental Rheumatology, vol. 31, no. 5, pp. 767-769.
Linklater H, Pipitone N, Rose MR, Norwood F, Campbell R, Salvarani C et al. Classifying idiopathic inflammatory myopathies: Comparing the performance of six existing criteria. Clinical and Experimental Rheumatology. 2013;31(5):767-769.
Linklater, Helen ; Pipitone, Nicolò ; Rose, Michael R. ; Norwood, Fiona ; Campbell, Richard ; Salvarani, Carlo ; Scott, David L. ; Gordon, Patrick. / Classifying idiopathic inflammatory myopathies : Comparing the performance of six existing criteria. In: Clinical and Experimental Rheumatology. 2013 ; Vol. 31, No. 5. pp. 767-769.
@article{3cda2c6111c74d5caaee57f720eb2b9b,
title = "Classifying idiopathic inflammatory myopathies: Comparing the performance of six existing criteria",
abstract = "Objective. Various criteria have been proposed to classify the inflammatory myositides (IIMs) polymyositis (PM) and dermatomyositis (DM). However, none have received universal acceptance. Our aim was to assess the performance of the main criteria used to classify IIM. Specialist consultant diagnosis was considered the gold standard. Methods. Patients attending King's College Hospital (KCH) or Reggio Emilia Hospital (REH) since 1990 with a diagnosis of IIM or non-inflammatory myopathy were identified, and their records and laboratory investigations retrospectively reviewed. Where the complete data required for the classification criteria or a final physician diagnosis was unavailable, patients were excluded. 52 patients with a specialist diagnosis of PM, DM, inclusion body myositis (IBM) or non-inflammatory myopathy were included. Agreement between specialist consultant diagnosis and classification criteria was measured using Cohen's kappa (?) statistics. Sensitivity and specificity were also calculated. Results. The Dalakas (2003) criteria demonstrated substantial agreement with specialist diagnosis: ?=0.69, sensitivity 77%, specificity 99%. The European Neuromuscular Centre criteria (ENMC) demonstrated fair agreement: ?=0.49, sensitivity 71%, specificity 82%. Other criteria performed less well. In particular, the Bohan and Peter criteria demonstrated a specificity of only 29%. Conclusions. The criteria of Dalakas (2003) agreed best with specialist consultant diagnosis. The criteria of Bohan and Peter demonstrated very poor specificity. Prospective studies are required to develop improved classification criteria.",
keywords = "Classification, Dermatomyositis, Inclusion body myositis, myositis, Polymyositis",
author = "Helen Linklater and Nicol{\`o} Pipitone and Rose, {Michael R.} and Fiona Norwood and Richard Campbell and Carlo Salvarani and Scott, {David L.} and Patrick Gordon",
journal = "Clinical and Experimental Rheumatology",
publisher = "Clinical and Experimental Rheumatology S.A.S.",
T1 - Classifying idiopathic inflammatory myopathies
T2 - Comparing the performance of six existing criteria
AU - Linklater, Helen
AU - Pipitone, Nicolò
AU - Rose, Michael R.
AU - Norwood, Fiona
AU - Campbell, Richard
AU - Salvarani, Carlo
AU - Scott, David L.
AU - Gordon, Patrick
N2 - Objective. Various criteria have been proposed to classify the inflammatory myositides (IIMs) polymyositis (PM) and dermatomyositis (DM). However, none have received universal acceptance. Our aim was to assess the performance of the main criteria used to classify IIM. Specialist consultant diagnosis was considered the gold standard. Methods. Patients attending King's College Hospital (KCH) or Reggio Emilia Hospital (REH) since 1990 with a diagnosis of IIM or non-inflammatory myopathy were identified, and their records and laboratory investigations retrospectively reviewed. Where the complete data required for the classification criteria or a final physician diagnosis was unavailable, patients were excluded. 52 patients with a specialist diagnosis of PM, DM, inclusion body myositis (IBM) or non-inflammatory myopathy were included. Agreement between specialist consultant diagnosis and classification criteria was measured using Cohen's kappa (?) statistics. Sensitivity and specificity were also calculated. Results. The Dalakas (2003) criteria demonstrated substantial agreement with specialist diagnosis: ?=0.69, sensitivity 77%, specificity 99%. The European Neuromuscular Centre criteria (ENMC) demonstrated fair agreement: ?=0.49, sensitivity 71%, specificity 82%. Other criteria performed less well. In particular, the Bohan and Peter criteria demonstrated a specificity of only 29%. Conclusions. The criteria of Dalakas (2003) agreed best with specialist consultant diagnosis. The criteria of Bohan and Peter demonstrated very poor specificity. Prospective studies are required to develop improved classification criteria.
AB - Objective. Various criteria have been proposed to classify the inflammatory myositides (IIMs) polymyositis (PM) and dermatomyositis (DM). However, none have received universal acceptance. Our aim was to assess the performance of the main criteria used to classify IIM. Specialist consultant diagnosis was considered the gold standard. Methods. Patients attending King's College Hospital (KCH) or Reggio Emilia Hospital (REH) since 1990 with a diagnosis of IIM or non-inflammatory myopathy were identified, and their records and laboratory investigations retrospectively reviewed. Where the complete data required for the classification criteria or a final physician diagnosis was unavailable, patients were excluded. 52 patients with a specialist diagnosis of PM, DM, inclusion body myositis (IBM) or non-inflammatory myopathy were included. Agreement between specialist consultant diagnosis and classification criteria was measured using Cohen's kappa (?) statistics. Sensitivity and specificity were also calculated. Results. The Dalakas (2003) criteria demonstrated substantial agreement with specialist diagnosis: ?=0.69, sensitivity 77%, specificity 99%. The European Neuromuscular Centre criteria (ENMC) demonstrated fair agreement: ?=0.49, sensitivity 71%, specificity 82%. Other criteria performed less well. In particular, the Bohan and Peter criteria demonstrated a specificity of only 29%. Conclusions. The criteria of Dalakas (2003) agreed best with specialist consultant diagnosis. The criteria of Bohan and Peter demonstrated very poor specificity. Prospective studies are required to develop improved classification criteria.
KW - Classification
KW - Dermatomyositis
KW - Inclusion body myositis
KW - myositis
KW - Polymyositis
JO - Clinical and Experimental Rheumatology
JF - Clinical and Experimental Rheumatology