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Title: | Assessment of the new 2012 EULAR/ACR clinical classification criteria for polymyalgia rheumatica: A prospective multicenter study | Authors: | Ozen, Gülsen Inanc, N. Unal, A.U. Bas, S. Kimyon, G. Kisacik, B. Onat, A.M. Murat, Sadiye Keskin, Havva Can, Meryem Mengi, Alperen Cakir, Necati Balkarli, Ayse Cobankara, Veli Yilmaz, Neslihan Yazici, Ayten Dogru, Atalay Sahin, Mehmet Sahin, Ali Gok, Kevser Senel, Soner Pamuk, Omer Nuri Yilmaz, Sema Bayindir, Ozun Aksu, Kenan Cagatay, Yonca Akyol, Lutfi Sayarlioglu, Mehmet Yildirim-Cetin, Gozde Yasar-Bilge, Sule Yagci, Ilker Aydin, Sibel Zehra Alibaz-Oner, Fatma Atagunduz, Pamir Direskeneli, Haner |
Keywords: | Classification criteria Polymyalgia rheumatica Rheumatoid arthritis acute phase protein 2012 European League Against Rheumatism American College of Rheumatology adult aged area under the curve Article Chuang criteria controlled clinical trial controlled study diagnostic procedure discriminant analysis disease classification female human inflammation intermethod comparison Jones criteria major clinical study male multicenter study Nobunaga criteria onset age pain assessment priority journal rheumatic polymyalgia rheumatoid arthritis sensitivity and specificity shoulder pain United States classification clinical trial differential diagnosis middle aged prospective study Aged Arthritis, Rheumatoid Diagnosis, Differential Female Humans Male Middle Aged Polymyalgia Rheumatica Prospective Studies Sensitivity and Specificity Shoulder Pain |
Publisher: | Journal of Rheumatology | Abstract: | Objective. To assess the performance of the new 2012 provisional European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) polymyalgia rheumatica (PMR) clinical classification criteria in discriminating PMR from other mimicking conditions compared with the previous 5 diagnostic criteria in a multicenter prospective study. Methods. Patients older than 50 years, presenting with new-onset bilateral shoulder pain with elevated acute-phase reactants (APR), were assessed for the fulfillment of the new and old classification/diagnostic criteria sets for PMR. At the end of the 1-year followup, 133 patients were diagnosed with PMR (expert opinion) and 142 with non-PMR conditions [69 rheumatoid arthritis (RA)]. Discriminating capacity, sensitivity, and specificity of the criteria sets were estimated. Results. Discriminating capacity of the new clinical criteria for PMR from non-PMR conditions and RA as estimated by area under the curve (AUC) were good with AUC of 0.736 and 0.781, respectively. The new criteria had a sensitivity of 89.5% and a specificity of 57.7% when tested against all non-PMR cases. When tested against all RA, seropositive RA, seronegative RA, and non-RA control patients, specificity changed to 66.7%, 100%, 20.7%, and 49.3%, respectively. Except for the Bird criteria, the 4 previous criteria had lower sensitivity and higher specificity (ranging from 83%-93%) compared with the new clinical criteria in discriminating PMR from all other controls. Conclusion. The new 2012 EULAR/ACR clinical classification criteria for PMR is highly sensitive; however, its ability to discriminate PMR from other inflammatory/noninflammatory shoulder conditions, especially from seronegative RA, is not adequate. Imaging and other modifications such as cutoff values for APR might increase the specificity of the criteria. © 2016. All rights reserved. | URI: | https://hdl.handle.net/11499/9614 https://doi.org/10.3899/jrheum.151103 |
ISSN: | 0315-162X |
Appears in Collections: | PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection Scopus İndeksli Yayınlar Koleksiyonu / Scopus Indexed Publications Collection Tıp Fakültesi Koleksiyonu WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection |
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