PMID- 16901958
OWN - NLM
STAT- MEDLINE
DCOM- 20070508
LR  - 20240322
IS  - 0003-4967 (Print)
IS  - 1468-2060 (Electronic)
IS  - 0003-4967 (Linking)
VI  - 66
IP  - 2
DP  - 2007 Feb
TI  - Development and validation of a consensus methodology for the classification of 
      the ANCA-associated vasculitides and polyarteritis nodosa for epidemiological 
      studies.
PG  - 222-7
AB  - 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.
FAU - Watts, Richard
AU  - Watts R
AD  - Department of Rheumatology, Ipswich Hospital NHS Trust, Heath Road, Ipswich IP4 
      5PD, UK. richard.watts@ipswichhospital.nhs.uk
FAU - Lane, Suzanne
AU  - Lane S
FAU - Hanslik, Thomas
AU  - Hanslik T
FAU - Hauser, Thomas
AU  - Hauser T
FAU - Hellmich, Bernhard
AU  - Hellmich B
FAU - Koldingsnes, Wenche
AU  - Koldingsnes W
FAU - Mahr, Alfred
AU  - Mahr A
FAU - Segelmark, Marten
AU  - Segelmark M
FAU - Cohen-Tervaert, Jan W
AU  - Cohen-Tervaert JW
FAU - Scott, David
AU  - Scott D
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PT  - Validation Study
DEP - 20060810
PL  - England
TA  - Ann Rheum Dis
JT  - Annals of the rheumatic diseases
JID - 0372355
RN  - 0 (Antibodies, Antineutrophil Cytoplasmic)
RN  - 0 (Biomarkers)
SB  - IM
MH  - *Algorithms
MH  - Antibodies, Antineutrophil Cytoplasmic/*blood
MH  - Biomarkers/blood
MH  - Churg-Strauss Syndrome/classification
MH  - Granulomatosis with Polyangiitis/classification
MH  - Humans
MH  - Polyarteritis Nodosa/*classification/epidemiology/immunology
MH  - Vasculitis/*classification/epidemiology/immunology
PMC - PMC1798520
COIS- Competing interests: None.
EDAT- 2006/08/12 09:00
MHDA- 2007/05/09 09:00
PMCR- 2010/02/01
CRDT- 2006/08/12 09:00
PHST- 2006/08/12 09:00 [pubmed]
PHST- 2007/05/09 09:00 [medline]
PHST- 2006/08/12 09:00 [entrez]
PHST- 2010/02/01 00:00 [pmc-release]
AID - ard.2006.054593 [pii]
AID - ar54593 [pii]
AID - 10.1136/ard.2006.054593 [doi]
PST - ppublish
SO  - Ann Rheum Dis. 2007 Feb;66(2):222-7. doi: 10.1136/ard.2006.054593. Epub 2006 Aug 
      10.