OBJECTIVE: Classification criteria for systemic sclerosis (SSc; scleroderma) are being updated jointly by the American College of Rheumatology and European League Against Rheumatism. Potential items for classification were reduced to 23 using Delphi and nominal group techniques. We evaluated the face, discriminant, and construct validity of the items to be further studied as potential criteria. METHODS: Face validity was evaluated using the frequency of items in patients sampled from the Canadian Scleroderma Research Group, 1000 Faces of Lupus, and the Pittsburgh, Toronto, Madrid, and Berlin connective tissue disease (CTD) databases. Patients with SSc (n = 783) were compared to 1,071 patients with diseases similar to SSc (mimickers): systemic lupus erythematosus (n = 499), myositis (n = 171), Sjögren's syndrome (n = 95), Raynaud's phenomenon (RP; n = 228), mixed CTD (n = 29), and idiopathic pulmonary arterial hypertension (PAH; n = 49). Discriminant validity was evaluated using odds ratios (ORs). For construct validity, empirical ranking was compared to expert ranking. RESULTS: Compared to mimickers, patients with SSc were more likely to have skin thickening (OR 427); telangiectasias (OR 91); anti-RNA polymerase III antibody (OR 75); puffy fingers (OR 35); finger flexion contractures (OR 29); tendon/bursal friction rubs (OR 27); anti-topoisomerase I antibody (OR 25); RP (OR 24); fingertip ulcers/pitting scars (OR 19); anticentromere antibody (OR 14); abnormal nailfold capillaries (OR 10); gastroesophageal reflux disease symptoms (OR 8); antinuclear antibody, calcinosis, dysphagia, and esophageal dilation (all OR 6); interstitial lung disease/pulmonary fibrosis (OR 5); and anti-PM-Scl antibody (OR 2). Reduced carbon monoxide diffusing capacity, PAH, and reduced forced vital capacity had ORs of <2. Renal crisis and digital pulp loss/acroosteolysis did not occur in SSc mimickers (OR not estimated). Empirical and expert ranking were correlated (Spearman's ρ = 0.53, P = 0.01). CONCLUSION: The candidate items have good face, discriminant, and construct validity. Further item reduction will be evaluated in prospective SSc and mimicker cases.
OBJECTIVE: Classification criteria for systemic sclerosis (SSc; scleroderma) are being updated jointly by the American College of Rheumatology and European League Against Rheumatism. Potential items for classification were reduced to 23 using Delphi and nominal group techniques. We evaluated the face, discriminant, and construct validity of the items to be further studied as potential criteria. METHODS: Face validity was evaluated using the frequency of items in patients sampled from the Canadian Scleroderma Research Group, 1000 Faces of Lupus, and the Pittsburgh, Toronto, Madrid, and Berlin connective tissue disease (CTD) databases. Patients with SSc (n = 783) were compared to 1,071 patients with diseases similar to SSc (mimickers): systemic lupus erythematosus (n = 499), myositis (n = 171), Sjögren's syndrome (n = 95), Raynaud's phenomenon (RP; n = 228), mixed CTD (n = 29), and idiopathic pulmonary arterial hypertension (PAH; n = 49). Discriminant validity was evaluated using odds ratios (ORs). For construct validity, empirical ranking was compared to expert ranking. RESULTS: Compared to mimickers, patients with SSc were more likely to have skin thickening (OR 427); telangiectasias (OR 91); anti-RNA polymerase III antibody (OR 75); puffy fingers (OR 35); finger flexion contractures (OR 29); tendon/bursal friction rubs (OR 27); anti-topoisomerase I antibody (OR 25); RP (OR 24); fingertip ulcers/pitting scars (OR 19); anticentromere antibody (OR 14); abnormal nailfold capillaries (OR 10); gastroesophageal reflux disease symptoms (OR 8); antinuclear antibody, calcinosis, dysphagia, and esophageal dilation (all OR 6); interstitial lung disease/pulmonary fibrosis (OR 5); and anti-PM-Scl antibody (OR 2). Reduced carbon monoxide diffusing capacity, PAH, and reduced forced vital capacity had ORs of <2. Renal crisis and digital pulp loss/acroosteolysis did not occur in SSc mimickers (OR not estimated). Empirical and expert ranking were correlated (Spearman's ρ = 0.53, P = 0.01). CONCLUSION: The candidate items have good face, discriminant, and construct validity. Further item reduction will be evaluated in prospective SSc and mimicker cases.
Authors: M Dougados; N Betteridge; G R Burmester; L Euller-Ziegler; F Guillemin; J Hirvonen; J Lloyd; S Ozen; J A P Da Silva; P Emery; J R Kalden; T Kvien; M Matucci-Cerinic; J Smolen Journal: Ann Rheum Dis Date: 2004-09 Impact factor: 19.103
Authors: E C LeRoy; C Black; R Fleischmajer; S Jablonska; T Krieg; T A Medsger; N Rowell; F Wollheim Journal: J Rheumatol Date: 1988-02 Impact factor: 4.666
Authors: L S Lonzetti; F Joyal; J P Raynauld; A Roussin; J R Goulet; E Rich; D Choquette; Y Raymond; J L Senécal Journal: Arthritis Rheum Date: 2001-03
Authors: E M Tan; A S Cohen; J F Fries; A T Masi; D J McShane; N F Rothfield; J G Schaller; N Talal; R J Winchester Journal: Arthritis Rheum Date: 1982-11
Authors: Rinaa S Punglia; Anthony V D'Amico; William J Catalona; Kimberly A Roehl; Karen M Kuntz Journal: N Engl J Med Date: 2003-07-24 Impact factor: 91.245
Authors: Christine A Peschken; Steven J Katz; Earl Silverman; Janet E Pope; Paul R Fortin; Christian Pineau; C Douglas Smith; Hector O Arbillaga; Dafna D Gladman; Murray Urowitz; Michel Zummer; Ann Clarke; Sasha Bernatsky; Marie Hudson Journal: J Rheumatol Date: 2009-04-15 Impact factor: 4.666
Authors: Frank van den Hoogen; Dinesh Khanna; Jaap Fransen; Sindhu R Johnson; Murray Baron; Alan Tyndall; Marco Matucci-Cerinic; Raymond P Naden; Thomas A Medsger; Patricia E Carreira; Gabriela Riemekasten; Philip J Clements; Christopher P Denton; Oliver Distler; Yannick Allanore; Daniel E Furst; Armando Gabrielli; Maureen D Mayes; Jacob M van Laar; James R Seibold; Laszlo Czirjak; Virginia D Steen; Murat Inanc; Otylia Kowal-Bielecka; Ulf Müller-Ladner; Gabriele Valentini; Douglas J Veale; Madelon C Vonk; Ulrich A Walker; Lorinda Chung; David H Collier; Mary Ellen Csuka; Barri J Fessler; Serena Guiducci; Ariane Herrick; Vivien M Hsu; Sergio Jimenez; Bashar Kahaleh; Peter A Merkel; Stanislav Sierakowski; Richard M Silver; Robert W Simms; John Varga; Janet E Pope Journal: Arthritis Rheum Date: 2013-10-03
Authors: Dinesh Khanna; Daniel E Furst; Yannick Allanore; Sangmee Bae; Vijay Bodukam; Philip J Clements; Maurizio Cutolo; Laszlo Czirjak; Christopher P Denton; Oliver Distler; Ulrich A Walker; Marco Matucci-Cerinic; Ulf Müller-Ladner; James R Seibold; Manjit Singh; Alan Tyndall Journal: Rheumatology (Oxford) Date: 2014-08-13 Impact factor: 7.580
Authors: Jaap Fransen; Sindhu R Johnson; Frank van den Hoogen; Murray Baron; Yannick Allanore; Patricia E Carreira; László Czirják; Christopher P Denton; Oliver Distler; Daniel E Furst; Armando Gabrielli; Ariane Herrick; Murat Inanc; Bashar Kahaleh; Otylia Kowal-Bielecka; Thomas A Medsger; Ulf Mueller-Ladner; Gabriela Riemekasten; Stanislaw Sierakowski; Gabriele Valentini; Doug Veale; Madelon C Vonk; Ulrich Walker; Lorinda Chung; Philip J Clements; David H Collier; Mary E Csuka; Sergio Jimenez; Peter A Merkel; James R Seibold; Richard Silver; Virginia Steen; Alan Tyndall; Marco Matucci-Cerinic; Janet E Pope; Dinesh Khanna Journal: Arthritis Care Res (Hoboken) Date: 2012-03 Impact factor: 4.794
Authors: Sara K Tedeschi; Sindhu R Johnson; Dimitrios Boumpas; David Daikh; Thomas Dörner; David Jayne; Diane Kamen; Kirsten Lerstrøm; Marta Mosca; Rosalind Ramsey-Goldman; Corine Sinnette; David Wofsy; Josef S Smolen; Raymond P Naden; Martin Aringer; Karen H Costenbader Journal: Arthritis Care Res (Hoboken) Date: 2018-02-22 Impact factor: 4.794
Authors: Pia Moinzadeh; Svetlana I Nihtyanova; Kevin Howell; Voon H Ong; Christopher P Denton Journal: Clin Rev Allergy Immunol Date: 2012-12 Impact factor: 8.667