Navegando por Palavras-chave "classification criteria"
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- ItemAcesso aberto (Open Access)Análise dos critérios diagnósticos, de classificação, atividade e gravidade de doença na esclerose sistêmica(Sociedade Brasileira de Reumatologia, 2004-02-01) Freire, Eutilia Andrade Medeiros; Ciconelli, Rozana Mesquita [UNIFESP]; Sampaio-Barros, Percival Degrava; Universidade Federal da Paraíba Departamento de Medicina Interna; Universidade Federal de São Paulo (UNIFESP); Universidade Estadual de Campinas (UNICAMP)The authors analyze the diagnostic and classification criteria in systemic sclerosis (SSc), the clinical variants diffuse and limited, and the recent concepts of SSc sine scleroderma and early SSc. It is also discussed the limitations in the validation of the methods to measure SSc activity and damage, and the recent efforts in order to standardize them.
- ItemSomente MetadadadosEvaluation of the European Spondylarthropathy Study Group (ESSG) preliminary classification criteria in Brazilian patients(Clinical & Exper Rheumatology, 1997-01-01) Cury, Silvia Elisa [UNIFESP]; Vilar, Maria José Pereira [UNIFESP]; Ciconelli, Rozana Mesquita [UNIFESP]; Ferraz, Marcos Bosi [UNIFESP]; Atra, Edgard [UNIFESP]; UNIV FED RIO GRANDE NORTE; Universidade Federal de São Paulo (UNIFESP)Objective: To evaluate the sensitivity and specificity of the ESSG criteria when applied to Brazilian patients with SpA and control patients with other rheumatic diseases.Methods: Seventy patients with spondylarthropathies and 62 patients with other rheumatic diseases were interviewed, examined and had their charts reviewed. The diagnoses of the diseases were based on published diagnostic guidelines or classification criteria. Data were also collected according to the ESSG criteria.Results: The sensitivity and specificity of the ESSG classification criteria were 98.5% and 88.7%, respectively. The sensitivities of the criteria in the different subgroups of SpA ranged from a low Of 97.7% in AS to a high of 100% in other SpA studied.Conclusion: Despite differences in the socio-cultural and geographic characteristics and in individual disease frequencies, the ESSG preliminary classification criteria performed well when applied to Brazilian patients.
- ItemSomente MetadadadosPerformance of the classification criteria in patients with late-onset axial spondyloarthritis(Taylor & Francis Ltd, 2018) Bendahan, Louise T. [UNIFESP]; Machado, Natalia P. [UNIFESP]; Mendes, Jamille G. [UNIFESP]; Oliveira, Thauana L. [UNIFESP]; Pinheiro, Marcelo M. [UNIFESP]Aim: To evaluate the performance of four different classification criteria for spondyloarthritis (SpA) in patients with late-onset symptoms and to compare the clinical, laboratory and radiographic outcomes among the patients with symptoms before and after 45 years of age. Patients and methods: A total of 329 patients with SpA were enrolled in this prospective cohort. Patients with psoriatic arthritis, reactive arthritis, colitis associated arthritis and peripheral or undifferentiated SpA were excluded. The remaining individuals were divided into two groups based on their ages at the time of onset of symptoms: from 16 to 45 years of age (adult-onset, A-O) and after 45 years of age (late-onset, L-O). The clinical data were collected, including BASDAI, BASFI, BASMI, mSASSS, ASDAS, as were concomitant diseases and medications, efficacy and safety data. The performance of four SpA classification criteria, including modified New York, ESSG, Amor and ASAS, was evaluated in both groups. p value <.05 was considered as significant. Results: Thirty-two patients (9.72%) had L-O axial SpA. Mean age of diagnosis and symptoms were 57.6 (8.0) years and 7.6 (5.1) years, respectively. L-O patients had statistically worse functional impairment and higher disease activity. However, they had lower radiographic sacroiliac and spine damage (p < .001). Conclusion: Our data showed that almost 10% of the patients with SpA had late-onset of symptoms. Moreover, they had higher disease activity, worse physical function and lower spine radiographic damage than A-O SpA patients. Additionally, the ASAS classification criteria had the best performance and might be used in clinical practice.
- ItemSomente MetadadadosValidação dos critérios de classificação para esclerose sistêmica do acr/eular 2013 em uma população ambulatorial do Brasil(Universidade Federal de São Paulo (UNIFESP), 2016-10-26) Araujo, Farley Carvalho [UNIFESP]; Silva, Cristiane Kayser Veiga da Silva [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objectives: The 1980 classification criteria for systemic sclerosis (SSc) have shown poor sensibility and do not contain important tools for the diagnosis of SSc. To improve sensitivity, the 2013 ACR/EULAR classification criteria for SSc were developed. Our research aimed to validate new ACR/EULAR criteria in brazilian patients with SSc and SSclike disorders. Secondary objectives were to evaluate the accuracy of the new criteria in early SSc patients, to evaluate different cut-off points for the new criteria, and to compare the sensitivity and the specificity of the new criteria with the 1980 classification criteria. Materials and methods: This was a cross-sectional study. The clinical and demographical data of SSc patients and patients with SSc-like disorder were collected using a standardized questioner and by the revision of their medical records. Results: A total of 319 patients were included, including 178 patients with SSc (122 with stablished SSc and 56 wih early SSc), and 141 controls. The mean age was higher in SSc patients than in the controls (51.3 versus 42.1 years, p<0.001). The 1980 criteria demonstrated a sensitivity of 68.5%, while the ACR/EULAR 2013 criteria demonstrated a sensitivity of 77.5% (p<0.001), without loss of the specificity (100% versus 98.5% for the 1980 criteria and the ACR/EULAR 2013 criteria, respectively). Sixteen of the 56 patients with early SSc (28.5%) fulfilled the ACR/EULAR 2013 criteria. Evaluating only the group of early SSc patients with Raynaud?s phenomenon and with positivity for specific autoantiboies plus scleroderma pattern (SD) in capillaroscopy, the ACR/EULAR 2013 criteria presented a higher sensitivity (95.5%), without loss of the specificity. Using a higher weight for the SD pattern in capillaroscopy (03 points), the sensitivity of the new criteria was of 100%. The group of patients with early SSc patients who were classified as SSc according the 2013 criteria showed a higher frequency for puffy fingers, fingertip pitting scars, pulmonary arterial hypertension and/or interstitial lung disease, telangiectasias, sclerodactyly and hemorrhages on capilaroscopy compared to patients who did not fulfilled the new criteria. ROC curve showed an area under curve of 0.999 (CI95% 0.998-1.000; p<0.001) when we compared the control group with patients with established SSc plus early SSc with specific autoantibodies and capilaroscopic SD pattern. The best cut-off was of ? 8 (sensitivity 100%; specificity 98%; positive likelihood ratio 47.6%; negative likelihood of 0). Conclusion: The ACR/EULAR 2013 classification criteria showed better sensitivity than the 1980 classification criteria. The new criteria presented validity and are a good option to classify SSc patients. To reduce the cut-off to 8 points can improve sensitivity, keeping 10 specificity. The increase in the weight for capilaroscopic SD pattern to 03 points improved the performance of the 2013 classification criteria.