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Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 J+Clin+Epidemiol 2014 ; 67 (6): 706-14 Nephropedia Template TP
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Systemic Sclerosis Classification Criteria: Developing methods for multi-criteria decision analysis with 1000Minds #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; 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 PMID24721558show ga
Objective: 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 between 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 re-ranked the cases. Consistency in rankings was evaluated using intraclass correlation coefficients (ICC). Results: Experts endorsed clarity (83%), comprehensibility (100%), face and content validity (100%). Criteria were weighted (points): finger skin thickening (14?22), finger-tip lesions (9?21), friction rubs (21), finger flexion contractures (16), pulmonary fibrosis (14), SSc-related antibodies (15), Raynaud?s 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%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% (23 to 14) and weighted. Our methods reflect the rigors of measurement science, and serves as a template for developing classification criteria.