Developing classification criteria for skin-predominant dermatomyositis: the Delphi process.
Journal
The British journal of dermatology
ISSN: 1365-2133
Titre abrégé: Br J Dermatol
Pays: England
ID NLM: 0004041
Informations de publication
Date de publication:
02 2020
02 2020
Historique:
accepted:
01
05
2019
pubmed:
3
5
2019
medline:
15
5
2021
entrez:
4
5
2019
Statut:
ppublish
Résumé
The European League Against Rheumatism/American College of Rheumatology classification criteria for inflammatory myopathies are able to classify patients with skin-predominant dermatomyositis (DM). However, approximately 25% of patients with skin-predominant DM do not meet two of the three hallmark skin signs and fail to meet the criteria. To develop a set of skin-focused classification criteria that will distinguish cutaneous DM from mimickers and allow a more inclusive definition of skin-predominant disease. An extensive literature review was done to generate items for the Delphi process. Items were grouped into categories of distribution, morphology, symptoms, antibodies, histology and contextual factors. Using REDCap™, participants rated these items in terms of appropriateness and distinguishing ability from mimickers. The relevance score ranged from 1 to 100, and the median score determined a rank-ordered list. A prespecified median score cut-off was decided by the steering committee and the participants. There was a pre-Delphi and two rounds of actual Delphi. There were 50 participating dermatologists and rheumatologists from North America, South America, Europe and Asia. After a cut-off score of 70 during the first round, 37 of the initial 54 items were retained and carried over to the next round. The cut-off was raised to 80 during round two and a list of 25 items was generated. This project is a key step in the development of prospectively validated classification criteria that will create a more inclusive population of patients with DM for clinical research. What's already known about this topic? Proper classification of patients with skin-predominant dermatomyositis (DM) is indispensable in the appropriate conduct of clinical/translational research in the field. The only validated European League Against Rheumatism/American College of Rheumatology criteria for idiopathic inflammatory myopathies are able to classify skin-predominant DM. However, a quarter of amyopathic patients still fail the criteria and does not meet the disease classification. What does this study add? A list of 25 potential criteria divided into categories of distribution, morphology, symptomatology, pathology and contextual factors has been generated after several rounds of consensus exercise among experts in the field of DM. This Delphi project is a prerequisite to the development of a validated classification criteria set for skin-predominant DM.
Sections du résumé
BACKGROUND
The European League Against Rheumatism/American College of Rheumatology classification criteria for inflammatory myopathies are able to classify patients with skin-predominant dermatomyositis (DM). However, approximately 25% of patients with skin-predominant DM do not meet two of the three hallmark skin signs and fail to meet the criteria.
OBJECTIVES
To develop a set of skin-focused classification criteria that will distinguish cutaneous DM from mimickers and allow a more inclusive definition of skin-predominant disease.
METHODS
An extensive literature review was done to generate items for the Delphi process. Items were grouped into categories of distribution, morphology, symptoms, antibodies, histology and contextual factors. Using REDCap™, participants rated these items in terms of appropriateness and distinguishing ability from mimickers. The relevance score ranged from 1 to 100, and the median score determined a rank-ordered list. A prespecified median score cut-off was decided by the steering committee and the participants. There was a pre-Delphi and two rounds of actual Delphi.
RESULTS
There were 50 participating dermatologists and rheumatologists from North America, South America, Europe and Asia. After a cut-off score of 70 during the first round, 37 of the initial 54 items were retained and carried over to the next round. The cut-off was raised to 80 during round two and a list of 25 items was generated.
CONCLUSIONS
This project is a key step in the development of prospectively validated classification criteria that will create a more inclusive population of patients with DM for clinical research. What's already known about this topic? Proper classification of patients with skin-predominant dermatomyositis (DM) is indispensable in the appropriate conduct of clinical/translational research in the field. The only validated European League Against Rheumatism/American College of Rheumatology criteria for idiopathic inflammatory myopathies are able to classify skin-predominant DM. However, a quarter of amyopathic patients still fail the criteria and does not meet the disease classification. What does this study add? A list of 25 potential criteria divided into categories of distribution, morphology, symptomatology, pathology and contextual factors has been generated after several rounds of consensus exercise among experts in the field of DM. This Delphi project is a prerequisite to the development of a validated classification criteria set for skin-predominant DM.
Types de publication
Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
410-417Subventions
Organisme : United States Department of Veterans Affairs
Pays : International
Investigateurs
Rachel Abuav
(R)
Rohit Aggarwal
(R)
Nidhi Avashia-Khemka
(N)
Jeffrey P Callen
(JP)
Adela Rambi G Cardones
(ARG)
Sarah S Chisolm
(SS)
Benjamin F Chong
(BF)
Lorinda Chung
(L)
Jennie T Clarke
(JT)
M Kari Connolly
(M)
Melissa Costner
(M)
Megan Curran
(M)
Lyubomir Dourmishev
(L)
Lisa A Drage
(LA)
Alisa N Femia
(AN)
Anthony P Fernandez
(AP)
Nicole Fett
(N)
Galen Foulke
(G)
Andrew G Franks
(AG)
Anna Haemel
(A)
Yasuhito Hamaguchi
(Y)
Christopher B Hansen
(CB)
Sotonye Imadojemu
(S)
Khor Jia Ker
(K)
Hee Joo Kim
(HJ)
Drew Jb Kurtzman
(DJ)
Christina Lam
(C)
Anne E Laumann
(AE)
Julie Lin
(J)
Jeffery D Mailhot
(JD)
Simon J Meggitt
(SJ)
Robert G Micheletti
(RG)
Sei-Ichiro Motegi
(SI)
Yoshinao Muro
(Y)
Elizabeth O'Brien
(E)
Lisa Pappas-Taffer
(L)
Taraneh Paravar
(T)
Aurora Parodi
(A)
David R Pearson
(DR)
Joanie Pinard
(J)
Sarika Ramachandran
(S)
Lisa G Rider
(LG)
Misha Rosenbach
(M)
Richard D Sontheimer
(RD)
Michael Sticherling
(M)
Cristián Andrés Vera Kellet
(CA)
Ruth Ann Vleugels
(RA)
David A Wetter
(DA)
Yukie Yamaguchi
(Y)
Commentaires et corrections
Type : CommentIn
Informations de copyright
Published 2019. This article is a U.S. Government work and is in the public domain in the USA.
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