Polymyalgia Rheumatica (2012 EULAR/ACR Provisional Criteria)
Review EULAR/ACR criteria for polymyalgia rheumatica
Classification criteria have been proposed by the European League Against Rheumatism and the American College of Rheumatology (EULAR/ACR). This is intended for use as a research tool to identify patients with polymalgia rheumatic (PMR) and not for the diagnosis of an individual patient as it still has limited diagnostic accuracy.
For the score without ultrasound, a cutoff score of ≥4 had 72% sensitivity and 65% specificity for discriminating all comparison subjects from PMR. The specificity was higher (79%) for discriminating shoulder conditions from PMR and lower (61%) for discriminating RA from PMR.
The c-statistic for the scoring algorithm was 75%. When studied, a total of 28% of PMR cases and 35% of comparison subjects were incorrectly classified.
For the score with ultrasound, a cutoff score ≥5 had 71% sensitivity and 70% specificity for discriminating all comparison subjects from PMR.
The specificity was higher (86%) for discriminating shoulder conditions from PMR and lower (65%) for discriminating RA from PMR.
The c-statistic for the scoring algorithm was 78%. When studied, 29% of PMR cases and 30% of comparison subjects were incorrectly classified.
- [1]Dasgupta B et al.: 2012 Provisional classification criteria for polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative.Arthritis and Rheumatism 2012, 64 (4): 943-54
Results
Real-time automated computation
To meet criteria for polymyalgia rheumatica, must have all 3 features: age ≥50, bilateral shoulder aching, and abnormal CRP and/or ESR, in addition to exceeding score threshold.
Classification criteria have been proposed by the European League Against Rheumatism and the American College of Rheumatology (EULAR/ACR). This is intended for use as a research tool to identify patients with polymalgia rheumatic (PMR) and not for the diagnosis of an individual patient as it still has limited diagnostic accuracy.
For the score without ultrasound, a cutoff score of ≥4 had 72% sensitivity and 65% specificity for discriminating all comparison subjects from PMR. The specificity was higher (79%) for discriminating shoulder conditions from PMR and lower (61%) for discriminating RA from PMR.
The c-statistic for the scoring algorithm was 75%. When studied, a total of 28% of PMR cases and 35% of comparison subjects were incorrectly classified.
For the score with ultrasound, a cutoff score ≥5 had 71% sensitivity and 70% specificity for discriminating all comparison subjects from PMR.
The specificity was higher (86%) for discriminating shoulder conditions from PMR and lower (65%) for discriminating RA from PMR.
The c-statistic for the scoring algorithm was 78%. When studied, 29% of PMR cases and 30% of comparison subjects were incorrectly classified.
- [1]Dasgupta B et al.: 2012 Provisional classification criteria for polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative.Arthritis and Rheumatism 2012, 64 (4): 943-54