Publication:
The International Criteria for Behçet's Disease (ICBD): A collaborative study of 27 countries on the sensitivity and specificity of the new criteria

Issued Date

2014-03-01

Resource Type

Article

ISSN

14683083
09269959

DOI

10.1111/jdv.12107

Other identifier(s)

2-s2.0-84894462149

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

Journal of the European Academy of Dermatology and Venereology. Vol.28, No.3 (2014), 338-347

Suggested Citation

F. Davatchi, S. Assaad-Khalil, K. T. Calamia, J. E. Crook, B. Sadeghi-Abdollahi, M. Schirmer, T. Tzellos, C. C. Zouboulis, M. Akhlagi, A. Al-Dalaan, Z. S. Alekberova, A. A. Ali, A. Altenburg, E. Arromdee, M. Baltaci, M. Bastos, S. Benamour, I. Ben Ghorbel, A. Boyvat, L. Carvalho, W. Chen, E. Ben-Chetrit, C. Chams-Davatchi, J. A. Correia, J. Crespo, C. Dias, Y. Dong, F. Paixão-Duarte, K. Elmuntaser, A. V. Elonakov, J. Graña Gil, A. A. Haghdoost, R. M. Hayani, H. Houman, A. R. Isayeva, A. R. Jamshidi, P. Kaklamanis, A. Kumar, A. Kyrgidis, W. Madanat, A. Nadji, K. Namba, S. Ohno, I. Olivieri, J. Vaz Patto, N. Pipitone, M. V. De Queiroz, F. Ramos, C. Resende, C. M. Rosa, C. Salvarani, M. J. Serra, F. Shahram, H. Shams, K. E. Sharquie, M. Sliti-Khanfir, T. Tribolet De Abreu, C. Vasconcelos, J. Vedes, B. Wechsler, Y. K. Cheng, Z. Zhang, N. Ziaei The International Criteria for Behçet's Disease (ICBD): A collaborative study of 27 countries on the sensitivity and specificity of the new criteria. Journal of the European Academy of Dermatology and Venereology. Vol.28, No.3 (2014), 338-347. doi:10.1111/jdv.12107 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/34287

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Thesis

Title

The International Criteria for Behçet's Disease (ICBD): A collaborative study of 27 countries on the sensitivity and specificity of the new criteria

Author(s)

F. Davatchi
 S. Assaad-Khalil
 K. T. Calamia
 J. E. Crook
 B. Sadeghi-Abdollahi
 M. Schirmer
 T. Tzellos
 C. C. Zouboulis
 M. Akhlagi
 A. Al-Dalaan
 Z. S. Alekberova
 A. A. Ali
 A. Altenburg
 E. Arromdee
 M. Baltaci
 M. Bastos
 S. Benamour
 I. Ben Ghorbel
 A. Boyvat
 L. Carvalho
 W. Chen
 E. Ben-Chetrit
 C. Chams-Davatchi
 J. A. Correia
 J. Crespo
 C. Dias
 Y. Dong
 F. Paixão-Duarte
 K. Elmuntaser
 A. V. Elonakov
 J. Graña Gil
 A. A. Haghdoost
 R. M. Hayani
 H. Houman
 A. R. Isayeva
 A. R. Jamshidi
 P. Kaklamanis
 A. Kumar
 A. Kyrgidis
 W. Madanat
 A. Nadji
 K. Namba
 S. Ohno
 I. Olivieri
 J. Vaz Patto
 N. Pipitone
 M. V. De Queiroz
 F. Ramos
 C. Resende
 C. M. Rosa
 C. Salvarani
 M. J. Serra
 F. Shahram
 H. Shams
 K. E. Sharquie
 M. Sliti-Khanfir
 T. Tribolet De Abreu
 C. Vasconcelos
 J. Vedes
 B. Wechsler
 Y. K. Cheng
 Z. Zhang
 N. Ziaei

Other Contributor(s)

Tehran University of Medical Sciences
 Alexandria Medical School
 Mayo Clinic in Jacksonville, Florida
 Medizinische Universitat Innsbruck
 Stadtisches Klinikum Dessau
 German Registry of Adamantiades-Behçet's Disease
 King Saud University
 V.A. Nasonova Research Institute of Rheumatology
 The Aga Khan University Hospital
 Mahidol University
 Hospital São Teotónio
 Centre Hospitalier Universitaire Ibn-Rochd
 Department of Internal Medicine
 Ankara Universitesi
 Hospital Geral de Santo Antonio
 Chang Gung University
 Hadassah University Medical Centre
 Centro Hospitalar e Universitario de Coimbra
 Sao Joao Hospital
 Peking Union Medical College
 Fernando da Fonseca Hospital
 Kadisia Clinic
 Complejo Hospitalario Universitario Juan Canalejo
 University of Baghdad
 Azerbaycan Tibb Universiteti
 Medical Center
 All India Institute of Medical Sciences, New Delhi
 Jordan Hospital
 Hokkaido University School of Medicine
 Potenza and Madonna Delle Grazie Hospital
 Instituto Portugues de Reumatologia
 Azienda Ospedaliera Santa Maria Nuova di Reggio Emilia
 Santa Maria Hospital, Lisbon
 University of Lisbon Faculty of Medicine, Institute of Molecular Medicine
 Santo António dos Capuchos Hospital
 Hospital do Espirito Santo
 Hospital Sousa Martins
 Hopital Universitaire Pitie Salpetriere
 Gleneagles Hospital
 Peking University

Abstract

Objective Behçet's disease (BD) is a chronic, relapsing, inflammatory vascular disease with no pathognomonic test. Low sensitivity of the currently applied International Study Group (ISG) clinical diagnostic criteria led to their reassessment. Methods An International Team for the Revision of the International Criteria for BD (from 27 countries) submitted data from 2556 clinically diagnosed BD patients and 1163 controls with BD-mimicking diseases or presenting at least one major BD sign. These were randomly divided into training and validation sets. Logistic regression, 'leave-one-country-out' cross-validation and clinical judgement were employed to develop new International Criteria for BD (ICBD) with the training data. Existing and new criteria were tested for their performance in the validation set. Results For the ICBD, ocular lesions, oral aphthosis and genital aphthosis are each assigned 2 points, while skin lesions, central nervous system involvement and vascular manifestations 1 point each. The pathergy test, when used, was assigned 1 point. A patient scoring ≥4 points is classified as having BD. In the training set, 93.9% sensitivity and 92.1% specificity were assessed compared with 81.2% sensitivity and 95.9% specificity for the ISG criteria. In the validation set, ICBD demonstrated an unbiased estimate of sensitivity of 94.8% (95% CI: 93.4-95.9%), considerably higher than that of the ISG criteria (85.0%). Specificity (90.5%, 95% CI: 87.9-92.8%) was lower than that of the ISG-criteria (96.0%), yet still reasonably high. For countries with at least 90%-of-cases and controls having a pathergy test, adding 1 point for pathergy test increased the estimate of sensitivity from 95.5% to 98.5%, while barely reducing specificity from 92.1% to 91.6%. Conclusion The new proposed criteria derived from multinational data exhibits much improved sensitivity over the ISG criteria while maintaining reasonable specificity. It is proposed that the ICBD criteria to be adopted both as a guide for diagnosis and classification of BD. © 2013 European Academy of Dermatology and Venereology.

Keyword(s)

Medicine

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https://repository.li.mahidol.ac.th/handle/123456789/34287

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