Genth E
Rheumaklinik, Aachen.
Z Rheumatol. 1996 Sep-Oct;55(5):319-30.
Nosologic criteria are important tools for diagnosis and categorization of rheumatic diseases, disease status and outcome. They have been developed predominantly for phenomenologic syndromes (of unknown etiology) and are standards of the scientific communication as well as necessary instruments for the selection of patient groups for investigations in different fields of rheumatology (epidemiology, etiology, pathogenesis, clinical rheumatology, diagnostics, therapy). Diagnostic criteria help to identify disease in individual patients. Classification criteria separate patients with a particular disease from patients without the disease and are useful to select and describe patient groups. Status indices assess disease activity and actual damage according to reversible or irreversible features respectively. Prognostic criteria differentiate patients with probably favorable or severe disease course or outcome, and outcome criteria are designed to assess the overall impact of a disease as dependent variables for clinical studies. This review describes the different types and purposes of nosological criteria in different rheumatic diseases as well as their problems. Some aspects of the actually used criteria especially from the "Diagnostic and Therapeutic Criteria Committee" of the American College of Rheumatology are critically commented.
疾病分类标准是诊断和归类风湿性疾病、疾病状态及预后的重要工具。它们主要是针对(病因不明的)现象学综合征制定的,是科学交流的标准,也是在风湿病学不同领域(流行病学、病因学、发病机制、临床风湿病学、诊断学、治疗学)选择患者群体进行研究的必要工具。诊断标准有助于识别个体患者的疾病。分类标准将患有特定疾病的患者与未患该疾病的患者区分开来,有助于选择和描述患者群体。状态指数分别根据可逆或不可逆特征评估疾病活动度和实际损害情况。预后标准区分疾病进程或预后可能良好或严重的患者,而结局标准旨在评估疾病作为临床研究因变量的总体影响。本综述描述了不同风湿性疾病中疾病分类标准的不同类型和用途及其存在的问题。对实际使用的标准,特别是美国风湿病学会“诊断与治疗标准委员会”的标准的某些方面进行了批判性评论。