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- Title
Validation of the 2022 American College of Rheumatology/EULAR classification criteria for Takayasu arteritis.
- Authors
Tomelleri, Alessandro; Padoan, Roberto; Kavadichanda, Chengappa G; Jose, Augustine; Singh, Kritika; Iorio, Luca; Rathore, Upendra; Rinaldi, Emma; Baldissera, Elena; Agarwal, Vikas; Dagna, Lorenzo; Campochiaro, Corrado; Misra, Durga Prasanna
- Abstract
Objectives The present study validates the 2022 ACR/European Alliance of Associations for Rheumatology (EULAR) classification criteria for Takayasu's arteritis (TAK), compared with the 1990 ACR TAK classification criteria. Methods The fulfilment of 2022 ACR/EULAR and 1990 ACR TAK criteria from four referral centres was assessed for TAK compared with extracranial giant cell arteritis (EC-GCA) and other controls. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), likelihood ratio of a positive test (LR+) or negative test (LR–), and area under receiver operating characteristics curve (AUC) were calculated. Results Among 504 patients with TAK (404 females) and 222 controls (151 females, 144 patients with EC-GCA), the 2022 ACR/EULAR criteria had better sensitivity (95.83% vs 82.94%) and NPV, but poorer specificity (63.51% vs 90.54%), PPV, LR+, LR– and AUC at the pre-determined cut-offs than the 1990 ACR criteria. The 2022 ACR/EULAR criteria had greater specificity (76.06% vs 57.62%) and AUC (0.845 vs 0.771), with similar sensitivity (93% vs 96.53%) in males as in females. The 2022 ACR/EULAR criteria performed similarly with only EC-GCA as controls (sensitivity 95.83%, specificity 60.42%, AUC 0.781). Sensitivity remained similar, whereas specificity was higher for 40–60 years vs <40 years. Cut-offs of ≥6 (sensitivity 91.87%, specificity 82.88%) and ≥7 (sensitivity 86.71%, specificity 86.49%), or removing the point for female sex (sensitivity 92.64%, specificity 81.08%) greatly improved the balance between sensitivity and specificity. Conclusion The poor specificity of the 2022 ACR/EULAR TAK criteria in real-life settings was improved by increasing the cut-off to 6 or 7, or removing the point for female sex.
- Subjects
UNITED States; PREDICTIVE tests; RHEUMATOLOGY; RESEARCH methodology; GIANT cell arteritis; TAKAYASU arteritis; COMPARATIVE studies; SENSITIVITY &; specificity (Statistics); RECEIVER operating characteristic curves
- Publication
Rheumatology, 2023, Vol 62, Issue 10, p3427
- ISSN
1462-0324
- Publication type
Article
- DOI
10.1093/rheumatology/kead161