Klinik uygulamada dev hücreli arterit için 2022 ACR/EULAR sınıflandırma kriterlerinin tanısal doğruluğunun değerlendirilmesi

Abstract

Amaç: Dev hücreli arterit (DHA) için 2022 Amerikan Romatoloji Koleji (ACR)/Avrupa Romatoloji Birliği (EULAR) sınıflandırma kriterleri, gelişmiş görüntüleme yöntemlerini dahil ederek ve büyük damar tutulumunu ele alarak tanı doğruluğunu artırmak için geliştirilmiştir. Bu çalışma, bu kriterlerin rutin kullanımda performansını değerlendirmektedir. Yöntemler: Bu çalışma retrospektif ve tek merkezliydi. Mart 2017'den Ocak 2024'e kadar üçüncü basamak bir romatoloji merkezinde rutin olarak takip edilen 25 DHA hastasını içeriyordu. Sınıflandırma kriterlerinin doğruluğu, duyarlılığı, özgüllüğü, pozitif ve negatif prediktif değerleri ve ROC analizi ile eğri altı alan (EAA) karşılaştırıldı. Bulgular: DHA için 2022 ACR/EULAR sınıflandırma kriterlerinin duyarlılığı (%92,0), özgüllüğü (%92,9), pozitif prediktif değeri (%92,0), negatif prediktif değeri (%92,9), doğruluğu (%92,4) ve EAA'sı (0,979 (0,925-0,998)) DHA için 1990 ACR sınıflandırma kriterlerinden daha yüksekti (%88,0, %85,7, %84,6, %88,9 ve %86,8 sırasıyla) ve EAA'daki fark istatistiksel olarak anlamlıydı (0,871 (0,770-0,973), p < 0,001) Sonuç: Bu bulgular, 2022 ACR/EULAR kriterlerinin duyarlılığı önemli ölçüde iyileştirdiğini ve 1990 kriterlerine kıyasla yeterli özgüllüğü koruduğunu, bu nedenle klinik uygulamada DHA tanısı için daha değerli hale geldiğini göstermektedir.

Keywords

• Dev hücreli arterit
• vaskülit
• sınıflandırma kriterleri

Evaluating the diagnostic accuracy of the 2022 ACR/EULAR classification criteria for giant cell arteritis in routine clinical practice

Abstract

Aims: The 2022 American College of Rheumatology (ACR)/European Alliance of Associations for Rheumatology (EULAR) classification criteria for giant cell arteritis (GCA) were developed to enhance diagnostic accuracy by incorporating advanced imaging modalities and addressing large vessel involvement. This study evaluates the performance of these criteria in routine clinical care. Methods: This study was retrospective and single-center. The results included 25 GCA patients routinely followed at a tertiary rheumatology center from March 2017 to January 2024. The accuracy, sensitivity, specificity, positive and negative predictive values, and area under the receiver operating characteristic (ROC) curve (AUC) of the classification criteria were compared. Results: The sensitivity (92.0%), specificity (92.9%), positive predictive value (92.0%), negative predictive value (92.9%), accuracy (92.4%) and AUC (0.979 (0.925-0.998)) of the 2022 ACR/EULAR classification criteria for GCA were higher than those of the 1990 ACR classification criteria for GCA (88.0%, 85.7%, 84.6%, 88.9% and 86.8%, respectively), and the difference in AUC was statistically significant (0.871 (0.770-0.973), p<0.001). Conclusion: These findings indicate that the 2022 ACR/EULAR criteria significantly improve the sensitivity and maintain adequate specificity compared to the 1990 criteria, making them a valuable tool for diagnosing GCA in clinical practice. The new classification criteria will help to select the right patients and will reduce clinical errors.

Keywords

• Giant cell arteritis
• vasculitis
• classification criteria

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