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Classifying idiopathic inflammatory myopathies: comparing the performance of six existing criteria.
[inclusion body myositis]
Various
criteria
have
been
proposed
to
classify
the
inflammatory
myositides
(
IIMs
)
polymyositis
(
PM
)
and
dermatomyositis
(
DM
)
.
However
,
none
have
received
universal
acceptance
.
Our
aim
was
to
assess
the
performance
of
the
main
criteria
used
to
classify
IIM
.
Specialist
consultant
diagnosis
was
considered
the
gold
standard
.
Patients
attending
King
's
College
Hospital
(
KCH
)
or
Reggio
Emilia
Hospital
(
REH
)
since
1990
with
a
diagnosis
of
IIM
or
non-
inflammatory
myopathy
were
identified
,
and
their
records
and
laboratory
investigations
retrospectively
reviewed
.
Where
the
complete
data
required
for
the
classification
criteria
or
a
final
physician
diagnosis
was
unavailable
,
patients
were
excluded
.
52
patients
with
a
specialist
diagnosis
of
PM
,
DM
,
inclusion
body
myositis
(
IBM
)
or
non-
inflammatory
myopathy
were
included
.
Agreement
between
specialist
consultant
diagnosis
and
classification
criteria
was
measured
using
Cohen
's
kappa
(
κ
)
statistics
.
Sensitivity
and
specificity
were
also
calculated
.
The
Dalakas
(
2003
)
criteria
demonstrated
substantial
agreement
with
specialist
diagnosis
:
κ
=
0
.
69
,
sensitivity
77
%
,
specificity
99
%
.
The
European
Neuromuscular
Centre
criteria
(
ENMC
)
demonstrated
fair
agreement
:
κ
=
0
.
49
,
sensitivity
71
%
,
specificity
82
%
.
Other
criteria
performed
less
well
.
In
particular
,
the
Bohan
and
Peter
criteria
demonstrated
a
specificity
of
only
29
%
.
The
criteria
of
Dalakas
(
2003
)
agreed
best
with
specialist
consultant
diagnosis
.
The
criteria
of
Bohan
and
Peter
demonstrated
very
poor
specificity
.
Prospective
studies
are
required
to
develop
improved
classification
criteria
.
Diseases
Validation
Diseases presenting
"inflammatory myositides"
symptom
inclusion body myositis
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