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2014 ; 67
(6
): 706-14
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Multicriteria decision analysis methods with 1000Minds for developing systemic
sclerosis classification criteria
#MMPMID24721558
Johnson SR
; Naden RP
; Fransen J
; van den Hoogen F
; Pope JE
; Baron M
; Tyndall A
; Matucci-Cerinic M
; Denton CP
; Distler O
; Gabrielli A
; van Laar JM
; Mayes M
; Steen V
; Seibold JR
; Clements P
; Medsger TA Jr
; Carreira PE
; Riemekasten G
; Chung L
; Fessler BJ
; Merkel PA
; Silver R
; Varga J
; Allanore Y
; Mueller-Ladner U
; Vonk MC
; Walker UA
; Cappelli S
; Khanna D
J Clin Epidemiol
2014[Jun]; 67
(6
): 706-14
PMID24721558
show ga
OBJECTIVES: Classification criteria for systemic sclerosis (SSc) are being
developed. The objectives were to develop an instrument for collating case data
and evaluate its sensibility; use forced-choice methods to reduce and weight
criteria; and explore agreement among experts on the probability that cases were
classified as SSc. STUDY DESIGN AND SETTING: A standardized instrument was tested
for sensibility. The instrument was applied to 20 cases covering a range of
probabilities that each had SSc. Experts rank ordered cases from highest to
lowest probability; reduced and weighted the criteria using forced-choice
methods; and reranked the cases. Consistency in rankings was evaluated using
intraclass correlation coefficients (ICCs). RESULTS: Experts endorsed clarity
(83%), comprehensibility (100%), face and content validity (100%). Criteria were
weighted (points): finger skin thickening (14-22), fingertip lesions (9-21),
friction rubs (21), finger flexion contractures (16), pulmonary fibrosis (14),
SSc-related antibodies (15), Raynaud phenomenon (13), calcinosis (12), pulmonary
hypertension (11), renal crisis (11), telangiectasia (10), abnormal nailfold
capillaries (10), esophageal dilation (7), and puffy fingers (5). The ICC across
experts was 0.73 [95% confidence interval (CI): 0.58, 0.86] and improved to 0.80
(95% CI: 0.68, 0.90). CONCLUSIONS: Using a sensible instrument and forced-choice
methods, the number of criteria were reduced by 39% (range, 23-14) and weighted.
Our methods reflect the rigors of measurement science and serve as a template for
developing classification criteria.