Department of Rheumatology, King's College Hospital NHS Foundation Trust, London SE5 9RS, UK.
Clin Exp Rheumatol. 2013 Sep-Oct;31(5):767-9. Epub 2013 Jun 14.
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.
已提出多种标准来对炎性肌病（IIM）中的多发性肌炎（PM）和皮肌炎（DM）进行分类。然而，这些标准均未得到普遍认可。我们的目的是评估用于分类 IIM 的主要标准的性能。专家顾问诊断被认为是金标准。
自 1990 年以来，在 King's College Hospital（KCH）或 Reggio Emilia Hospital（REH）就诊的患有 IIM 或非炎性肌病的患者被确定，并对其病历和实验室检查进行回顾性审查。如果无法获得分类标准或最终医生诊断所需的完整数据，则排除患者。共纳入 52 例专家诊断为 PM、DM、包涵体肌炎（IBM）或非炎性肌病的患者。使用 Cohen's kappa（κ）统计量评估专家顾问诊断与分类标准之间的一致性。还计算了敏感性和特异性。
Dalakas（2003）标准与专家诊断具有显著一致性：κ=0.69，敏感性为 77%，特异性为 99%。欧洲神经肌肉中心标准（ENMC）显示出适度的一致性：κ=0.49，敏感性为 71%，特异性为 82%。其他标准的表现较差。特别是，Bohan 和 Peter 标准的特异性仅为 29%。
Dalakas（2003）标准与专家顾问诊断最吻合。Bohan 和 Peter 标准特异性非常差。需要前瞻性研究来制定改进的分类标准。
