dc.description.abstract | Objective. To assess the performance of the new 2012 provisional European League Against Rheumatism (EULAR)/ American College of Rheumatology (ACR) polymyalgia rheumatica (PMR) clinical classification criteria in discriminating PMR from other mimicking conditions compared with the previous 5 diagnostic criteria in a multicenter prospective study. Methods. Patients older than 50 years, presenting with new-onset bilateral shoulder pain with elevated acute-phase reactants (APR), were assessed for the fulfillment of the new and old classification/diagnostic criteria sets for PMR. At the end of the 1-year followup, 133 patients were diagnosed with PMR (expert opinion) and 142 with non-PMR conditions [69 rheumatoid arthritis (RA)]. Discriminating capacity, sensitivity, and specificity of the criteria sets were estimated. Results. Discriminating capacity of the new clinical criteria for PMR from non-PMR conditions and RA as estimated by area under the curve (AUC) were good with AUC of 0.736 and 0.781, respectively. The new criteria had a sensitivity of 89.5% and a specificity of 57.7% when tested against all non-PMR cases. When tested against all RA, seropositive RA, seronegative RA, and non-RA control patients, specificity changed to 66.7%, 100%, 20.7%, and 49.3%, respectively. Except for the Bird criteria, the 4 previous criteria had lower sensitivity and higher specificity (ranging from 83%-93%) compared with the new clinical criteria in discriminating PMR from all other controls. Conclusion. The new 2012 EULAR/ ACR clinical classification criteria for PMR is highly sensitive; however, its ability to discriminate PMR from other inflammatory/noninflammatory shoulder conditions, especially from seronegative RA, is not adequate. Imaging and other modifications such as cutoff values for APR might increase the specificity of the criteria. | en_US |
dc.department-temp | [Ozen, Gulsen -- Inanc, Nevsun -- Unal, Ali Ugur -- Bas, Seda -- Alibaz-Oner, Fatma -- Atagunduz, Pamir -- Direskeneli, Haner] Marmara Univ, Fac Med, Dept Rheumatol, Muhsin Yazicioglu Str 10, TR-34890 Istanbul, Turkey -- [Yagci, Ilker] Marmara Univ, Fac Med, Dept Phys Therapy & Rehabil, Istanbul, Turkey -- [Murat, Sadiye -- Keskin, Havva] Goztepe Medeniyet Univ, Fac Med, Dept Phys Med & Rehabil, Istanbul, Turkey -- [Can, Meryem -- Mengi, Alperen -- Cakir, Necati] Fatih Sultan Mehmet Educ & Res Hosp, Dept Rheumatol, Istanbul, Turkey -- [Yilmaz, Neslihan -- Cagatay, Yonca] Bilim Univ, Fac Med, Dept Rheumatol, Istanbul, Turkey -- [Kimyon, Gezmis -- Kisacik, Bunyamin -- Onat, Ahmet Mesut] Gaziantep Univ, Fac Med, Dept Rheumatol, Gaziantep, Turkey -- [Balkarli, Ayse -- Cobankara, Veli] Pamukkale Univ, Fac Med, Dept Rheumatol, Denizli, Turkey -- [Yazici, Ayten] Sakarya Educ & Res Hosp, Dept Rheumatol, Sakarya, Turkey -- [Dogru, Atalay -- Sahin, Mehmet] Suleyman Demirel Univ, Dept Rheumatol, Isparta, Turkey -- [Sahin, Ali] Cumhuriyet Univ, Fac Med, Dept Rheumatol, Sivas, Turkey -- [Gok, Kevser -- Senel, Soner] Erciyes Univ, Fac Med, Dept Rheumatol, Kayseri, Turkey -- [Pamuk, Omer Nuri] Trakya Univ, Fac Med, Dept Rheumatol, Edirne, Turkey -- [Yilmaz, Sema] Selcuk Univ, Selcuklu Fac Med, Dept Rheumatol, Konya, Turkey -- [Bayindir, Ozun -- Aksu, Kenan] Ege Univ, Fac Med, Dept Rheumatol, Izmir, Turkey -- [Akyol, Lutfi -- Sayarlioglu, Mehmet] Ondokuz Mayis Univ, Fac Med, Dept Rheumatol, Samsun, Turkey -- [Yildirim-Cetin, Gozde] Sutcu Imam Univ, Fac Med, Dept Rheumatol, Kahramanmaras, Turkey -- [Yasar-Bilge, Sule] Yunus Emre Govt Hosp, Dept Rheumatol, Eskisehir, Turkey -- [Aydin, Sibel Zehra] Univ Ottawa, Sch Med, Dept Rheumatol, Ottawa, ON, Canada | en_US |