First external validation of sensitivity and specificity of the European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) classification criteria for idiopathic inflammatory myopathies with a Japanese cohort

Masatoshi Jinnin, Akiko Ohta, Shoichiro Ishihara, Hirofumi Amano, Tatsuya Atsumi, Manabu Fujimoto, Takashi Kanda, Yasushi Kawaguchi, Atsushi Kawakami, Akio Mimori, Tsuneyo Mimori, Toshihide Mimura, Yoshinao Muro, Hajime Sano, Jun Shimizu, Tsutomu Takeuchi, Yoshiya Tanaka, Kazuhiko Yamamoto, Takayuki Sumida, Hitoshi Kohsaka

Research output: Contribution to journalArticle

Abstract

Objective: To externally validate the performance of the new European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) classification criteria set for idiopathic inflammatory myopathies (IIM) with a Japanese cohort. Methods: This study included 420 IIM and 402 non-IIM cases. Probability of having IIM in each patient was calculated using the collected data set. The cut-off probability was set at 55%, as recommended by EULAR/ACR. Patients classified as IIM by the criteria were further subclassified with classification trees. Results: When the probability cut-off was set at 55%, the sensitivity/specificity of the new criteria to diagnose IIM were 89.3%/91.0% in the total cohort, 88.1%/95.1% without muscle biopsy data and 90.4%/65.5% with biopsy data. The cohort included 12 overlap syndrome patients with biopsy data, who were included as non-IIM cases in accordance with traditional Japanese methods. When they were included in the IIM cases, the specificity in patients with biopsy increased to 74.4%. The sensitivity/specificity of the new criteria to diagnose polymyositis/dermatomyositis (PM/DM) plus juvenile and amyopathic DM in the Japanese cohort was 87.4%/92.4%, which were greater than those of the Tanimoto's criteria revised to enable classification of amyopathic DM (ADM) (71.2%/87.8%) and were comparable with those of Bohan & Peter's criteria to diagnose those diseases except for ADM (88.4%/88.3%). Conclusions: Our study externally validated high specificity of the new criteria for the first time, although with several limitations, including low percentage of child patients. The new criteria have higher sensitivity and/or specificity in classification of PM/DM than the previously reported criteria, demonstrating its usefulness for interethnic patients.

Original languageEnglish
Article number215488
JournalAnnals of the rheumatic diseases
DOIs
Publication statusAccepted/In press - 2019 Jan 1

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Myositis
Biopsy
Sensitivity and Specificity
Dermatomyositis
Muscle
Rheumatology
Rheumatic Diseases
Muscles

Keywords

  • autoimmune diseases
  • dermatomyositis
  • polymyositis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Rheumatology
  • Immunology
  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

First external validation of sensitivity and specificity of the European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) classification criteria for idiopathic inflammatory myopathies with a Japanese cohort. / Jinnin, Masatoshi; Ohta, Akiko; Ishihara, Shoichiro; Amano, Hirofumi; Atsumi, Tatsuya; Fujimoto, Manabu; Kanda, Takashi; Kawaguchi, Yasushi; Kawakami, Atsushi; Mimori, Akio; Mimori, Tsuneyo; Mimura, Toshihide; Muro, Yoshinao; Sano, Hajime; Shimizu, Jun; Takeuchi, Tsutomu; Tanaka, Yoshiya; Yamamoto, Kazuhiko; Sumida, Takayuki; Kohsaka, Hitoshi.

In: Annals of the rheumatic diseases, 01.01.2019.

Research output: Contribution to journalArticle

Jinnin, M, Ohta, A, Ishihara, S, Amano, H, Atsumi, T, Fujimoto, M, Kanda, T, Kawaguchi, Y, Kawakami, A, Mimori, A, Mimori, T, Mimura, T, Muro, Y, Sano, H, Shimizu, J, Takeuchi, T, Tanaka, Y, Yamamoto, K, Sumida, T & Kohsaka, H 2019, 'First external validation of sensitivity and specificity of the European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) classification criteria for idiopathic inflammatory myopathies with a Japanese cohort', Annals of the rheumatic diseases. https://doi.org/10.1136/annrheumdis-2019-215488
Jinnin, Masatoshi ; Ohta, Akiko ; Ishihara, Shoichiro ; Amano, Hirofumi ; Atsumi, Tatsuya ; Fujimoto, Manabu ; Kanda, Takashi ; Kawaguchi, Yasushi ; Kawakami, Atsushi ; Mimori, Akio ; Mimori, Tsuneyo ; Mimura, Toshihide ; Muro, Yoshinao ; Sano, Hajime ; Shimizu, Jun ; Takeuchi, Tsutomu ; Tanaka, Yoshiya ; Yamamoto, Kazuhiko ; Sumida, Takayuki ; Kohsaka, Hitoshi. / First external validation of sensitivity and specificity of the European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) classification criteria for idiopathic inflammatory myopathies with a Japanese cohort. In: Annals of the rheumatic diseases. 2019.
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abstract = "Objective: To externally validate the performance of the new European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) classification criteria set for idiopathic inflammatory myopathies (IIM) with a Japanese cohort. Methods: This study included 420 IIM and 402 non-IIM cases. Probability of having IIM in each patient was calculated using the collected data set. The cut-off probability was set at 55{\%}, as recommended by EULAR/ACR. Patients classified as IIM by the criteria were further subclassified with classification trees. Results: When the probability cut-off was set at 55{\%}, the sensitivity/specificity of the new criteria to diagnose IIM were 89.3{\%}/91.0{\%} in the total cohort, 88.1{\%}/95.1{\%} without muscle biopsy data and 90.4{\%}/65.5{\%} with biopsy data. The cohort included 12 overlap syndrome patients with biopsy data, who were included as non-IIM cases in accordance with traditional Japanese methods. When they were included in the IIM cases, the specificity in patients with biopsy increased to 74.4{\%}. The sensitivity/specificity of the new criteria to diagnose polymyositis/dermatomyositis (PM/DM) plus juvenile and amyopathic DM in the Japanese cohort was 87.4{\%}/92.4{\%}, which were greater than those of the Tanimoto's criteria revised to enable classification of amyopathic DM (ADM) (71.2{\%}/87.8{\%}) and were comparable with those of Bohan & Peter's criteria to diagnose those diseases except for ADM (88.4{\%}/88.3{\%}). Conclusions: Our study externally validated high specificity of the new criteria for the first time, although with several limitations, including low percentage of child patients. The new criteria have higher sensitivity and/or specificity in classification of PM/DM than the previously reported criteria, demonstrating its usefulness for interethnic patients.",
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T1 - First external validation of sensitivity and specificity of the European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) classification criteria for idiopathic inflammatory myopathies with a Japanese cohort

AU - Jinnin, Masatoshi

AU - Ohta, Akiko

AU - Ishihara, Shoichiro

AU - Amano, Hirofumi

AU - Atsumi, Tatsuya

AU - Fujimoto, Manabu

AU - Kanda, Takashi

AU - Kawaguchi, Yasushi

AU - Kawakami, Atsushi

AU - Mimori, Akio

AU - Mimori, Tsuneyo

AU - Mimura, Toshihide

AU - Muro, Yoshinao

AU - Sano, Hajime

AU - Shimizu, Jun

AU - Takeuchi, Tsutomu

AU - Tanaka, Yoshiya

AU - Yamamoto, Kazuhiko

AU - Sumida, Takayuki

AU - Kohsaka, Hitoshi

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objective: To externally validate the performance of the new European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) classification criteria set for idiopathic inflammatory myopathies (IIM) with a Japanese cohort. Methods: This study included 420 IIM and 402 non-IIM cases. Probability of having IIM in each patient was calculated using the collected data set. The cut-off probability was set at 55%, as recommended by EULAR/ACR. Patients classified as IIM by the criteria were further subclassified with classification trees. Results: When the probability cut-off was set at 55%, the sensitivity/specificity of the new criteria to diagnose IIM were 89.3%/91.0% in the total cohort, 88.1%/95.1% without muscle biopsy data and 90.4%/65.5% with biopsy data. The cohort included 12 overlap syndrome patients with biopsy data, who were included as non-IIM cases in accordance with traditional Japanese methods. When they were included in the IIM cases, the specificity in patients with biopsy increased to 74.4%. The sensitivity/specificity of the new criteria to diagnose polymyositis/dermatomyositis (PM/DM) plus juvenile and amyopathic DM in the Japanese cohort was 87.4%/92.4%, which were greater than those of the Tanimoto's criteria revised to enable classification of amyopathic DM (ADM) (71.2%/87.8%) and were comparable with those of Bohan & Peter's criteria to diagnose those diseases except for ADM (88.4%/88.3%). Conclusions: Our study externally validated high specificity of the new criteria for the first time, although with several limitations, including low percentage of child patients. The new criteria have higher sensitivity and/or specificity in classification of PM/DM than the previously reported criteria, demonstrating its usefulness for interethnic patients.

AB - Objective: To externally validate the performance of the new European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) classification criteria set for idiopathic inflammatory myopathies (IIM) with a Japanese cohort. Methods: This study included 420 IIM and 402 non-IIM cases. Probability of having IIM in each patient was calculated using the collected data set. The cut-off probability was set at 55%, as recommended by EULAR/ACR. Patients classified as IIM by the criteria were further subclassified with classification trees. Results: When the probability cut-off was set at 55%, the sensitivity/specificity of the new criteria to diagnose IIM were 89.3%/91.0% in the total cohort, 88.1%/95.1% without muscle biopsy data and 90.4%/65.5% with biopsy data. The cohort included 12 overlap syndrome patients with biopsy data, who were included as non-IIM cases in accordance with traditional Japanese methods. When they were included in the IIM cases, the specificity in patients with biopsy increased to 74.4%. The sensitivity/specificity of the new criteria to diagnose polymyositis/dermatomyositis (PM/DM) plus juvenile and amyopathic DM in the Japanese cohort was 87.4%/92.4%, which were greater than those of the Tanimoto's criteria revised to enable classification of amyopathic DM (ADM) (71.2%/87.8%) and were comparable with those of Bohan & Peter's criteria to diagnose those diseases except for ADM (88.4%/88.3%). Conclusions: Our study externally validated high specificity of the new criteria for the first time, although with several limitations, including low percentage of child patients. The new criteria have higher sensitivity and/or specificity in classification of PM/DM than the previously reported criteria, demonstrating its usefulness for interethnic patients.

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KW - dermatomyositis

KW - polymyositis

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