Weight of Salivary-Gland Ultrasonography compared to Other items of the 2016 ACR/EULAR Classification Criteria for Primary Sjögren's Syndrome

Autor: Caroline H. Shiboski, Daniel Hammenfors, Sandrine Jousse-Joulin, Valérie Devauchelle-Pensec, Divi Cornec, Chiara Baldini, Manuel Ramos-Casals, Alan N. Baer, Tatsufumi Nakamura, Malin V. Jonsson, Pilar Brito-Zerón, Emmanuel Nowak, Wan-Fai Ng, Hideki Nakamura, Raphaèle Seror, Benjamin A Fisher, Alain Saraux, Hendrika Bootsma, Florence Gatineau, Astrid Rasmussen, S. De Vita, Simon J. Bowman, Xavier Mariette, Vera Milic, Arjan Vissink, Thomas Dörner, Francesca Barone
Přispěvatelé: CHRU Brest - Service de Rhumatologie (CHU - BREST - Rhumato), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Lymphocyte B et Auto-immunité (LBAI), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'Investigation Clinique (CIC - Brest), Rheumatology Unit (Rheum Unit - PISA), University of Pisa - Università di Pisa, Johns Hopkins University School of Medicine [Baltimore], Department of Rheumatology, University Hospital Birmingham, Department of Rheumatology and Clinical Immunology Groningen (Dep Rheum - GRONINGEN), University Medical Center Groningen [Groningen] (UMCG), H. CIMA-Sanitas, Barcelona, Medical Centre for Rheumatology, Berlin, Department of Medical Area, University Hospital Santa Maria della Misericordia, Udine, Ospedale 'Santa Maria della Misericordia' = University Hospital 'Santa Maria della Misericordia', Haukeland University Hospital, University of Bergen (UiB), Department of Clinical Science and Department of Rheumatology, Bergen, Institute of Clinical Dentistry [Bergen, Norway], Department of Paediatric Rheumatology, Hôpital de Bicêtre, APHP, National Reference Centre for Auto-inflammatory Diseases, University of Paris Sud, CHU de Bicêtre, University of Belgrade [Belgrade], Department of Immunology and Rheumatology, Nagasaki, Japan, Institute of Cellular Medicine [Newcastle], Newcastle University [Newcastle], Oklahoma Medical Research Foundation, Medical Research Foundation, Departments of Orofacial Sciences and Pediatrics, University of California, Department of Radiology and Cancer Biology, Nagasaki, Department of Oral & Maxillofacial Surgery & Maxillofacial Prosthetics, University Medical Center Groningen and University of Groningen, Translational Immunology Groningen (TRIGR), Personalized Healthcare Technology (PHT), Lymphocytes B, Autoimmunité et Immunothérapies (LBAI), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-LabEX IGO Immunothérapie Grand Ouest-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Journal of Internal Medicine
Journal of Internal Medicine, Wiley, 2019, ⟨10.1111/joim.12992⟩
Journal of Internal Medicine, 287(2), 180-188. Wiley
ISSN: 0954-6820
1365-2796
DOI: 10.1111/joim.12992
Popis: Objective: Major salivary gland ultrasonography (SGUS) is widely used for the diagnosis of primary Sjögren’s syndrome (pSS). Our objective was to assess the contribution of SGUS compared to other items of the 2016 ACR/EULAR pSS classification criteria, based on expert opinion. Methods: A secure web‐based relational database was used by 24 experts from 14 countries to assess 512 realistic vignettes developed from data of patients with suspected pSS. Each vignette provided classification criteria items and information on history, clinical symptoms and SGUS findings. Each expert assessed 64 vignettes, and each vignette was assessed by 3 experts. A diagnosis of pSS was defined according to at least 2 of 3 experts. Validation was performed in the independent French DiapSS cohort of patients with suspected pSS. Results: A criteria‐based pSS diagnosis and SGUS findings were independently associated with an expert diagnosis of pSS (P < 0.001). The derived diagnostic weights of individual items in the 2016 ACR/EULAR criteria including SGUS were as follows: anti‐SSA, 3; focus score ≥ 1, 3; SGUS score ≥ 2, 1; positive Schirmer’s test, 1; dry mouth, 1; and salivary flow rate < 0.1 mL/min, 1. The corrected C statistic area under the curve for the new weighted score was 0.96. Adding SGUS improves the sensitivity from 90.2 % to 95.6% with a quite similar specificity 84.1% versus 82.6%. Results were similar in the DiapSS cohort: adding SGUS improves the sensitivity from 87% to 93%. Conclusion: SGUS had similar weight compared to minor items, and its addition improves the performance of the 2016 ACR/EULAR classification criteria. acceptedVersion
Databáze: OpenAIRE
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