The Validation of the 2023 ACR/EULAR Antiphospholipid Syndrome Classification Criteria in a Cohort from Turkey
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View abstract on PubMed
Summary
This summary is machine-generated.The 2023 American College of Rheumatology/European League Against Rheumatism classification criteria for antiphospholipid syndrome (APS) showed high specificity but low sensitivity in this cohort. Excluding livedo racemosa improved specificity to 100%.
Area Of Science
- Rheumatology
- Immunology
- Clinical Diagnostics
Background
- Antiphospholipid syndrome (APS) diagnosis relies on classification criteria.
- The 2023 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) criteria were developed to refine APS classification.
- Validation in diverse patient cohorts is crucial for assessing criterion performance.
Purpose Of The Study
- To validate the performance of the 2023 ACR/EULAR classification criteria for APS.
- To compare the diagnostic accuracy of the new criteria against the revised Sapporo criteria.
- To evaluate the impact of specific clinical findings, such as livedo racemosa, on criterion performance.
Main Methods
- A cohort of 193 patients was studied, including 83 with APS and 110 without (SLE and other conditions).
- Sensitivity, specificity, and Area Under the Curve (AUC) were calculated for the 2023 ACR/EULAR criteria and revised Sapporo criteria.
- Agreement between the two sets of criteria was assessed using the kappa test.
Main Results
- The 2023 ACR/EULAR criteria demonstrated a sensitivity of 73% and specificity of 94% (AUC: 0.836).
- The revised Sapporo criteria showed a sensitivity of 66% and specificity of 98%.
- Excluding livedo racemosa from the analysis resulted in 100% specificity for the 2023 ACR/EULAR criteria, with a sensitivity of 62% (AUC: 0.813).
Conclusions
- The 2023 ACR/EULAR criteria exhibited high specificity but limited sensitivity in this APS cohort.
- The specificity reached 100% when livedo findings were excluded, suggesting potential over-specificity with this feature.
- Further evaluation is needed to optimize the sensitivity of the new criteria for broader APS classification.
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