The Use and Misuse of Classification and Diagnostic Criteria for Complex Diseases

Editorials1 September 1998The Use and Misuse of Classification and Diagnostic Criteria for Complex DiseasesGene G. Hunder, MDGene G. Hunder, MDMayo School of Medicine; Rochester, MN 55905Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-129-5-199809010-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The vasculitides are a group of complex multisystem disorders that are linked by the presence of necrotizing inflammatory lesions in blood vessels. Arteries and other vessels of various sizes and locations in the body may be involved, resulting in a wide spectrum of manifestations [1]. The causes and pathogenetic mechanisms of vasculitides are poorly understood but are probably diverse. Their severity, course, and outcomes vary. Within the vasculitides, there seem to be several distinct clinical syndromes. However, even these have multiple presentations, and the different syndromes have overlapping findings. These factors have made it difficult to define these diseases and ...References1. Valente RM, Hall S, O'Duffy JD, Conn DL. Vasculitis and related disorders. In: Kelley WN, Harris ED, Ruddy S, Sledge CB, eds. Textbook of Rheumatology. 5th ed. Philadelphia: WB Saunders; 1997:1079-122. Google Scholar2. Lie JT. The classification and diagnosis of vasculitis in large and medium-sized blood vessels. Pathol Ann. 1987; 22:125-62. Google Scholar3. Fries JF, Hochberg MC, Medsger TA Jr, Hunder GG, Bombardier C. Criteria for rheumatic disease. Different types and different functions. The American College of Rheumatology Diagnostic and Therapeutic Criteria Committee. Arthritis Rheum. 1994; 37:454-62. Google Scholar4. Bloch DA, Moses LE, Michel BA. Statistical approaches to classification. Methods for developing classification and other criteria rules. Arthritis Rheum. 1990; 33:1137-44. Google Scholar5. Gabriel SE. Classification of rheumatic diseases. In: Klippel JH, Dieppe PA, eds. Rheumatology. 2d ed. St. Louis: Mosby; 1994:3.1-3.4. Google Scholar6. Hunder GG, Arend WP, Bloch DA, Calabrese LH, Fauci AS, Fries JF, et al. The American College of Rheumatology 1990 criteria for the classification of vasculitis. Introduction. Arthritis Rheum. 1990; 33:1065-7. Google Scholar7. Bloch DA, Michel BA, Hunder GG, McShane DJ, Arend WP, Calabrese LH, et al. The American College of Rheumatology 1990 criteria for the classification of vasculitis. Patients and methods. Arthritis Rheum. 1990; 33:1068-73. Google Scholar8. Rao JK, Allen NB, Pincus T. Limitations of the 1990 American College of Rheumatology classification criteria in the diagnosis of vasculitis. Ann Intern Med. 1998; 129:345-52. Google Scholar9. Jennette JC, Falk RJ, Andrassy K, Bacon PA, Churg J, Gross WL, et al. Nomenclature of systemic vasculitides. Proposal of an international consensus conference. Arthritis Rheum. 1994; 37:187-92. Google Scholar Author, Article, and Disclosure InformationAuthors: Gene G. Hunder, MDAffiliations: Mayo School of Medicine; Rochester, MN 55905Corresponding Author: Gene G. Hunder, MD, Mayo School of Medicine, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoLimitations of the 1990 American College of Rheumatology Classification Criteria in the Diagnosis of Vasculitis Jaya K. Rao , Nancy B. Allen , and Theodore Pincus Metrics Cited byMapping the architecture of the temporal artery with photoacoustic imaging for diagnosing giant cell arteritisFrameworks, Terminology and Definitions Used for the Classification of Voice Disorders: A Scoping ReviewPaediatric Behçet's Disease: A Comprehensive Review with an Emphasis on Monogenic MimicsHalo score (temporal artery, its branches and axillary artery) as a diagnostic, prognostic and disease monitoring tool for Giant Cell Arteritis (GCA)An update on the epidemiology of ANCA-associated vasculitisIntroduction: Dedicated Mondays and an Acquaintance-Based View of Behçet SyndromeEuropean consensus-based recommendations for diagnosis and treatment of immunoglobulin A vasculitis—the SHARE initiativeSystematic Review of the Yield of Temporal Artery Biopsy for Suspected Giant Cell ArteritisGout Classification and DiagnosisClassification Criteria for Axial SpondyloarthritisChildhood systemic vasculitisDiagnosis of Gout: A Systematic Review in Support of an American College of Physicians Clinical Practice GuidelineSydne J. Newberry, PhD, John D. FitzGerald, MD, PhD, Aneesa Motala, BA, Marika Booth, MS, Margaret A. Maglione, MPP, Dan Han, MPA, Abdul Tariq, BS, Claire E. O'Hanlon, MPP, Roberta Shanman, MLS, Whitney Dudley, BS, and Paul G. Shekelle, MD, PhDPediatric Vasculitis: Classification and Clinical ApproachBaseline clinical predictors of an ultimate giant cell arteritis diagnosis in patients referred to temporal artery biopsyEditorial: Shifting the Goal Posts: Treatment Recommendations for Ankylosing Spondylitis and the Newly Defined Condition of Nonradiographic Axial SpondyloarthritisDiagnosis and/or classification of vasculitisVasculitis: do we know more to classify better?Distinctions Between Diagnostic and Classification Criteria?The use and abuse of diagnostic/classification criteriaThe diagnosis and classification of giant cell arteritisDisease Classification/Diagnosis CriteriaCriteria for Gout Diagnosis?The new ASAS classification criteria for axial and peripheral spondyloarthritis: promises and pitfallsEvaluation of Classification Systems for Nonspecific Idiopathic Orbital InflammationIncreased Sensitivity of the European Medicines Agency Algorithm for Classification of Childhood Granulomatosis with PolyangiitisMedium-size-vessel vasculitisIntroduction: Dedicated Mondays and an Acquaintance-Based View of Behçet's SyndromeOverlap Syndromes: Exploring the Genetic UnderpinningsDiagnóstico de artropatía microcristalinaA paradigm of diagnostic criteria for polyarteritis nodosa: Analysis of a series of 949 patients with vasculitidesGiant Cell ArteritisThe ArthritidesAsthma drug use and the development of Churg–Strauss syndrome (CSS)A new international classification of childhood vasculitisSystemic VasculitisReply: Nomenclature of Kawasaki disease/syndromeFrühdiagnose rheumatischer Erkrankungen—Classification of the vasculitides: Are they clinically useful?Vasculites pulmonares: quando suspeitar e como fazer o diagnósticoThe challenge of diagnosis and classification in early ankylosing spondylitis: Do we need new criteria?Diagnóstico de la gotaNew insights into culture driven disordersChurg-Strauss syndromeThe epidemiology of the primary systemic vasculitides in northwest Spain: Implications of the Chapel Hill Consensus Conference definitionsT cell V β repertoires in childhood vasculitidesClassification of childhood arthritisPrevalence of serious eosinophilia and incidence of Churg-Strauss syndrome in a cohort of asthma patientsEPIDEMIOLOGY OF THE VASCULITIDESImproved differentiation between Churg-Strauss syndrome and Wegener's granulomatosis by an artificial neural networkThe relationship of asthma therapy and Churg-Strauss syndrome: NIH workshop summary reportTest characteristics of immunofluorescence and ELISA tests in 856 consecutive patients with possible ANCA-associated conditionsSynovial Fluid Analysis for Diagnosis of Intercritical GoutEliseo Pascual, MD, PhD, Enrique Batlle-Gualda, MD, PhD, Agustín Martínez, MD, José Rosas, MD, and Paloma Vela, MD, PhDThe American College of Rheumatology criteria for the classification of systemic lupus erythematosus: Strengths, weaknesses, and opportunities for improvementSystemic Vasculitis in Adults in Northwestern Spain, 1988-1997: Clinical and Epidemiologic AspectsComparative clinical and epidemiological study of hypersensitivity vasculitis versus Henoch-Schönlein purpura in adultsAmerican College of Rheumatology Criteria for the Diagnosis of VasculitisStephen G. Gelfand, MDAmerican College of Rheumatology Criteria for the Diagnosis of VasculitisIsrael Heller, MD, Aharon Isakov, MD, and Marcel Topilsky, MD 1 September 1998Volume 129, Issue 5Page: 417-418KeywordsBiopsyHypersensitivityLesionsPathogensPositive predictive valueResearch laboratoriesRheumatologySpecificityVasculitisWegener granulomatosis ePublished: 15 August 2000 Issue Published: 1 September 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...