title: Items for developing revised classification criteria in systemic sclerosis: Results of a consensus exercise.
abstract: OBJECTIVE
  Classification criteria for systemic sclerosis (SSc; scleroderma) are being updated. Our objective was to select a set of items potentially useful for the classification of SSc using consensus procedures, including the Delphi and nominal group techniques (NGT).
  
  
  METHODS
  Items were identified through 2 independent consensus exercises performed by the Scleroderma Clinical Trials Consortium and the European League Against Rheumatism Scleroderma Trials and Research Group. The first-round items from both exercises were collated and redundancies were removed, leaving 168 items. A 3-round Delphi exercise was performed using a 1-9 scale (where 1 = completely inappropriate and 9 = completely appropriate) and a consensus meeting using NGT was conducted. During the last Delphi round, the items were ranked on a 1-10 scale.
  
  
  RESULTS
  In round 1, 106 experts rated the 168 items. Those with a median score of <4 were removed, resulting in a list of 102 items. In round 2, the items were again rated for appropriateness and subjected to a consensus meeting using NGT by European and North American SSc experts (n = 16), resulting in 23 items. In round 3, SSc experts (n = 26) then individually scored each of the 23 items in a last Delphi round using an appropriateness score (1-9) and ranking their 10 most appropriate items for the classification of SSc. Presence of skin thickening, SSc-specific autoantibodies, abnormal nailfold capillary pattern, and Raynaud's phenomenon ranked highest in the final list that also included items indicating internal organ involvement.
  
  
  CONCLUSIONS
  The Delphi exercise and NGT resulted in a set of 23 items for the classification of SSc that will be assessed for their discriminative properties in a prospective study.
authors: Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
authors: Jaap
authors: J
authors: Fransen
authors: Sindhu R
authors: SR
authors: Johnson
authors: Frank
authors: F
authors: van den Hoogen
authors: Murray
authors: M
authors: Baron
authors: Yannick
authors: Y
authors: Allanore
authors: Patricia E
authors: PE
authors: Carreira
authors: László
authors: L
authors: Czirják
authors: Christopher P
authors: CP
authors: Denton
authors: Oliver
authors: O
authors: Distler
authors: Daniel E
authors: DE
authors: Furst
authors: Armando
authors: A
authors: Gabrielli
authors: Ariane
authors: A
authors: Herrick
authors: Murat
authors: M
authors: Inanc
authors: Bashar
authors: B
authors: Kahaleh
authors: Otylia
authors: O
authors: Kowal-Bielecka
authors: Thomas A
authors: TA
authors: Medsger
authors: Ulf
authors: U
authors: Mueller-Ladner
authors: Gabriela
authors: G
authors: Riemekasten
authors: Stanislaw
authors: S
authors: Sierakowski
authors: Gabriele
authors: G
authors: Valentini
authors: Doug
authors: D
authors: Veale
authors: Madelon C
authors: MC
authors: Vonk
authors: Ulrich
authors: U
authors: Walker
authors: Lorinda
authors: L
authors: Chung
authors: Philip J
authors: PJ
authors: Clements
authors: David H
authors: DH
authors: Collier
authors: Mary E
authors: ME
authors: Csuka
authors: Sergio
authors: S
authors: Jimenez
authors: Peter A
authors: PA
authors: Merkel
authors: James R
authors: JR
authors: Seibold
authors: Richard
authors: R
authors: Silver
authors: Virginia
authors: V
authors: Steen
authors: Alan
authors: A
authors: Tyndall
authors: Marco
authors: M
authors: Matucci-Cerinic
authors: Janet E
authors: JE
authors: Pope
authors: Dinesh
authors: D
authors: Khanna
mesh_terms: D032921:Consensus; D003697:Delphi Technique; D005260:Female; D006801:Humans; D012595:Scleroderma, Systemic / Q000145:classification* / Q000175:diagnosis