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EULAR points to consider in the development of classification and diagnostic criteria in systemic vasculitis

Basu, Neil; Watts, Richard; Bajema, Ingeborg; Baslund, Bo; Bley, Thorsten; Boers, Maarten; Brogan, Paul; Calabrese, Len; Cid, Maria C. and Cohen-Tervaert, Jan Willem, et al. (2010) In Annals of the Rheumatic Diseases 69(10). p.1744-1750
Abstract
Objectives The systemic vasculitides are multiorgan diseases where early diagnosis and treatment can significantly improve outcomes. Robust nomenclature reduces diagnostic delay. However, key aspects of current nomenclature are widely perceived to be out of date, these include disease definitions, classification and diagnostic criteria. Therefore, the aim of the present work was to identify deficiencies and provide contemporary points to consider for the development of future definitions and criteria in systemic vasculitis. Methods The expert panel identified areas of concern within existing definitions/criteria. Consequently, a systematic literature review was undertaken looking to address these deficiencies and produce 'points to... (More)
Objectives The systemic vasculitides are multiorgan diseases where early diagnosis and treatment can significantly improve outcomes. Robust nomenclature reduces diagnostic delay. However, key aspects of current nomenclature are widely perceived to be out of date, these include disease definitions, classification and diagnostic criteria. Therefore, the aim of the present work was to identify deficiencies and provide contemporary points to consider for the development of future definitions and criteria in systemic vasculitis. Methods The expert panel identified areas of concern within existing definitions/criteria. Consequently, a systematic literature review was undertaken looking to address these deficiencies and produce 'points to consider' in accordance with standardised European League Against Rheumatism (EULAR) operating procedures. In the absence of evidence, expert consensus was used. Results There was unanimous consensus for re-evaluating existing definitions and developing new criteria. A total of 17 points to consider were proposed, covering 6 main areas: biopsy, laboratory testing, diagnostic radiology, nosology, definitions and research agenda. Suggestions to improve and expand current definitions were described including the incorporation of anti-neutrophil cytoplasm antibody and aetiological factors, where known. The importance of biopsy in diagnosis and exclusion of mimics was highlighted, while equally emphasising its problems. Thus, the role of alternative diagnostic tools such as MRI, ultrasound and surrogate markers were also discussed. Finally, structures to develop future criteria were considered. Conclusions Limitations in current classification criteria and definitions for vasculitis have been identified and suggestions provided for improvement. Additionally it is proposed that, in combination with the updated evidence, these should form the basis of future attempts to develop and validate revised criteria and definitions of vasculitis. (Less)
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published
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Annals of the Rheumatic Diseases
volume
69
issue
10
pages
1744 - 1750
publisher
British Medical Association
external identifiers
  • wos:000282006800003
  • scopus:77955735444
ISSN
1468-2060
DOI
10.1136/ard.2009.119032
language
English
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yes
id
0d113ac6-3a26-4acc-a40d-10cc4bc613d7 (old id 1696068)
date added to LUP
2010-10-25 12:29:42
date last changed
2018-12-02 03:57:08
@article{0d113ac6-3a26-4acc-a40d-10cc4bc613d7,
  abstract     = {Objectives The systemic vasculitides are multiorgan diseases where early diagnosis and treatment can significantly improve outcomes. Robust nomenclature reduces diagnostic delay. However, key aspects of current nomenclature are widely perceived to be out of date, these include disease definitions, classification and diagnostic criteria. Therefore, the aim of the present work was to identify deficiencies and provide contemporary points to consider for the development of future definitions and criteria in systemic vasculitis. Methods The expert panel identified areas of concern within existing definitions/criteria. Consequently, a systematic literature review was undertaken looking to address these deficiencies and produce 'points to consider' in accordance with standardised European League Against Rheumatism (EULAR) operating procedures. In the absence of evidence, expert consensus was used. Results There was unanimous consensus for re-evaluating existing definitions and developing new criteria. A total of 17 points to consider were proposed, covering 6 main areas: biopsy, laboratory testing, diagnostic radiology, nosology, definitions and research agenda. Suggestions to improve and expand current definitions were described including the incorporation of anti-neutrophil cytoplasm antibody and aetiological factors, where known. The importance of biopsy in diagnosis and exclusion of mimics was highlighted, while equally emphasising its problems. Thus, the role of alternative diagnostic tools such as MRI, ultrasound and surrogate markers were also discussed. Finally, structures to develop future criteria were considered. Conclusions Limitations in current classification criteria and definitions for vasculitis have been identified and suggestions provided for improvement. Additionally it is proposed that, in combination with the updated evidence, these should form the basis of future attempts to develop and validate revised criteria and definitions of vasculitis.},
  author       = {Basu, Neil and Watts, Richard and Bajema, Ingeborg and Baslund, Bo and Bley, Thorsten and Boers, Maarten and Brogan, Paul and Calabrese, Len and Cid, Maria C. and Cohen-Tervaert, Jan Willem and Flores-Suarez, Luis Felipe and Fujimoto, Shouichi and de Groot, Kirsten and Guillevin, Loic and Hatemi, Gulen and Hauser, Thomas and Jayne, David and Jennette, Charles and Kallenberg, Cees G. M. and Kobayashi, Shigeto and Little, Mark A. and Mahr, Alfred and McLaren, John and Merkel, Peter A. and Ozen, Seza and Puechal, Xavier and Rasmussen, Niels and Salama, Alan and Salvarani, Carlo and Savage, Caroline and Scott, David G. I. and Segelmark, Mårten and Specks, Ulrich and Sunderkoeetter, Cord and Suzuki, Kazuo and Tesar, Vladimir and Wiik, Allan and Yazici, Hasan and Luqmani, Raashid},
  issn         = {1468-2060},
  language     = {eng},
  number       = {10},
  pages        = {1744--1750},
  publisher    = {British Medical Association},
  series       = {Annals of the Rheumatic Diseases},
  title        = {EULAR points to consider in the development of classification and diagnostic criteria in systemic vasculitis},
  url          = {http://dx.doi.org/10.1136/ard.2009.119032},
  volume       = {69},
  year         = {2010},
}