Development of the 2023 ACR/EULAR Antiphospholipid Syndrome Classification Criteria, Phase III-D Report: Multicriteria Decision Analysis.

Autor: Barbhaiya M; Hospital for Special Surgery, Weill Cornell Medicine, New York City, New York., Zuily S; CHRU-Nancy, Nancy University Hospital, INSERM UMR-S 1116, University of Lorraine, F-54000 Nancy, France., Amigo MC; ABC Medical Center, Mexico City, Mexico., Andrade D; University of São Paulo, Sao Paulo, Brazil., Avcin T; Children's Hospital, University Medical Center, University of Ljubljana, Ljubljana, Slovenia., Bertolaccini ML; King's College London British Heart Foundation Centre of Excellence, London, United Kingdom., Branch DW; University of Utah Health, Salt Lake City., Costedoat-Chalumeau N; APHP, Hopital Cochin, Université de Paris, Centre de Recherche Épidémiologie et Biostatistiques de Sorbonne Paris Cité, F-75004 Paris, France., Crowther M; McMaster University, Hamilton, Ontario, Canada., Ramires de Jesus G; Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil., Devreese KMJ; Ghent University Hospital, Ghent University, Ghent, Belgium., Frances C; Tenon Hospital, Paris, France., Garcia D; University of Washington, Seattle., Gómez-Puerta JA; Hospital Clinic and IDIBAPS, Barcelona, Spain., Guillemin F; CHRU, INSERM, Université de Lorraine and INSPIIRE, Université de Lorraine, INSERM, Nancy, France., Levine SR; State University of New York Downstate Health Sciences University, and Kings County Hospital Center, and Maimonides Medical Center, Brooklyn, New York., Levy RA; Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil, and Glaxo Smith Kline, Upper Providence, Pennsylvania., Lockshin MD; Hospital for Special Surgery, Weill Cornell Medicine, New York City, New York., Ortel TL; Duke University School of Medicine, Durham, North Carolina., Petri M; Hopkins University School of Medicine, Baltimore, Maryland., Sanna G; Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom., Sciascia S; San Giovanni Bosco Hospital and University of Turin, Turin, Italy., Seshan SV; Weill Cornell Medicine, New York City, New York., Tektonidou MG; National and Kapodistrian University of Athens, Athens, Greece., Wahl D; CHRU-Nancy, Nancy University Hospital, INSERM UMR-S 1116, University of Lorraine, F-54000 Nancy, France., Willis R; University of Texas Medical Branch at Galveston., Yelnik C; Centre Hospitalier Universitaire de Lille, INSERM, UMR 1167, F-59000 Lille, France., Hendry A; Middlemore Hospital, Auckland, New Zealand., Naden R, Costenbader K; Brigham and Women's Hospital, Boston, Massachusetts., Erkan D; Hospital for Special Surgery, Weill Cornell Medicine, New York City, New York.
Jazyk: angličtina
Zdroj: Arthritis care & research [Arthritis Care Res (Hoboken)] 2024 Aug 12. Date of Electronic Publication: 2024 Aug 12.
DOI: 10.1002/acr.25415
Abstrakt: Objective: The 2023 American College of Rheumatology/EULAR antiphospholipid syndrome (APS) classification criteria development, which aimed to identify patients with high likelihood of APS for research, employed a four-phase methodology. Phase I and II resulted in 27 proposed candidate criteria, which are organized into laboratory and clinical domains. Here, we summarize the last stage of phase III efforts, employing a consensus-based multicriteria decision analysis (MCDA) to weigh candidate criteria and identify an APS classification threshold score.
Methods: We evaluated 192 unique, international real-world patients referred for "suspected APS" with a wide range of APS manifestations. Using proposed candidate criteria, subcommittee members rank ordered 20 representative patients from highly unlikely to highly likely to have APS. During an in-person meeting, the subcommittee refined definitions and participated in an MCDA exercise to identify relative weights of candidate criteria. Using consensus decisions and pairwise criteria comparisons, 1000Minds software assigned criteria weights, and we rank ordered 192 patients by their additive scores. A consensus-based threshold score for APS classification was set.
Results: Premeeting evaluation of 20 representative patients demonstrated variability in APS assessment. MCDA resolved 81 pairwise decisions; relative weights identified domain item hierarchy. After assessing 192 patients by weights and additive scores, the Steering Committee reached consensus that APS classification should require separate clinical and laboratory scores, rather than a single-aggregate score, to ensure high specificity.
Conclusion: Using MCDA, candidate criteria preliminary weights were determined. Unlike other disease classification systems using a single-aggregate threshold score, separate clinical and laboratory domain thresholds were incorporated into the new APS classification criteria.
(© 2024 American College of Rheumatology.)
Databáze: MEDLINE
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