Document Detail

Development and validation of a consensus methodology for the classification of the ANCA-associated vasculitides and polyarteritis nodosa for epidemiological studies.
MedLine Citation:
PMID:  16901958     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The classification of antineutrophil cytoplasmic antibody-associated vasculitis (AAV) and polyarteritis nodosa (PAN) for epidemiology studies is confusing. The existing schemes such as American College of Rheumatology (ACR) criteria, Chapel Hill Consensus Conference (CHCC) definitions and Lanham criteria produce overlapping and conflicting classifications, making it difficult to compare incidence figures.
AIM: To develop a consensus method of using these criteria and definitions for epidemiological studies to permit comparison without confounding by classification.
METHODS: A stepwise algorithm was developed by consensus between a group of doctors interested in the epidemiology of vasculitis. The aim was to categorise patients with Wegener's granulomatosis, microscopic polyangiitis (MPA), Churg-Strauss syndrome (CSS) and PAN into single clinically relevant categories. The ACR and Lanham criteria for CSS, and ACR criteria for Wegener's granulomatosis were applied first, as these were considered to be the most specific. Surrogate markers for Wegener's granulomatosis were included to distinguish Wegener's granulomatosis from MPA. MPA was classified using the CHCC definition and surrogate markers for renal vasculitis. Finally, PAN was classified using the CHCC definition. The algorithm was validated by application to 20 cases from each centre and 99 from a single centre, followed by a paper case exercise.
RESULTS: A four-step algorithm was devised. It successfully categorises patients into a single classification. There was good correlation between observers in the paper case exercise (91.5%; unweighted kappa = 0.886).
CONCLUSION: The algorithm achieves its aim of reliably classifying patients into a single category. The use of the algorithm in epidemiology studies should permit comparison between geographical areas.
Richard Watts; Suzanne Lane; Thomas Hanslik; Thomas Hauser; Bernhard Hellmich; Wenche Koldingsnes; Alfred Mahr; Mårten Segelmark; Jan W Cohen-Tervaert; David Scott
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't; Validation Studies     Date:  2006-08-10
Journal Detail:
Title:  Annals of the rheumatic diseases     Volume:  66     ISSN:  0003-4967     ISO Abbreviation:  Ann. Rheum. Dis.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-01-23     Completed Date:  2007-05-08     Revised Date:  2014-07-29    
Medline Journal Info:
Nlm Unique ID:  0372355     Medline TA:  Ann Rheum Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  222-7     Citation Subset:  IM    
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MeSH Terms
Antibodies, Antineutrophil Cytoplasmic / blood*
Biological Markers / blood
Churg-Strauss Syndrome / classification
Polyarteritis Nodosa / classification*,  epidemiology,  immunology
Vasculitis / classification*,  epidemiology,  immunology
Wegener Granulomatosis / classification
Reg. No./Substance:
0/Antibodies, Antineutrophil Cytoplasmic; 0/Biological Markers

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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