title: Comparison of the American-European Consensus Group Sjogren's syndrome classification criteria to newly proposed American College of Rheumatology criteria in a large, carefully characterised sicca cohort.
abstract: OBJECTIVE
  To compare the performance of the American-European Consensus Group (AECG) and the newly proposed American College of Rheumatology (ACR) classification criteria for Sjögren's Syndrome (SS) in a well-characterised sicca cohort, given ongoing efforts to resolve discrepancies and weaknesses in the systems.
  
  
  METHODS
  In a multidisciplinary clinic for the evaluation of sicca, we assessed features of salivary and lacrimal gland dysfunction and autoimmunity as defined by tests of both AECG and ACR criteria in 646 participants. Global gene expression profiles were compared in a subset of 180 participants.
  
  
  RESULTS
  Application of the AECG and ACR criteria resulted in classification of 279 and 268 participants with SS, respectively. Both criteria were met by 244 participants (81%). In 26 of the 35 AECG+/ACR participants, the minor salivary gland biopsy focal score was ≥1 (74%), while nine had positive anti-Ro/La (26%). There were 24 AECG-/ACR+ who met ACR criteria mainly due to differences in the scoring of corneal staining. All patients with SS, regardless of classification, had similar gene expression profiles, which were distinct from the healthy controls.
  
  
  CONCLUSIONS
  The two sets of classification criteria yield concordant results in the majority of cases and gene expression profiling suggests that patients meeting either set of criteria are more similar to other SS participants than to healthy controls. Thus, there is no clear evidence for increased value of the new ACR criteria over the old AECG criteria from the clinical or biological perspective. It is our contention, supported by this report, that improvements in diagnostic acumen will require a more fundamental understanding of the pathogenic mechanisms than is at present available.
authors: Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, , Oklahoma City, Oklahoma, USA.
authors: Astrid
authors: A
authors: Rasmussen
authors: John A
authors: JA
authors: Ice
authors: He
authors: H
authors: Li
authors: Kiely
authors: K
authors: Grundahl
authors: Jennifer A
authors: JA
authors: Kelly
authors: Lida
authors: L
authors: Radfar
authors: Donald U
authors: DU
authors: Stone
authors: Kimberly S
authors: KS
authors: Hefner
authors: Juan-Manuel
authors: JM
authors: Anaya
authors: Michael
authors: M
authors: Rohrer
authors: Rajaram
authors: R
authors: Gopalakrishnan
authors: Glen D
authors: GD
authors: Houston
authors: David M
authors: DM
authors: Lewis
authors: James
authors: J
authors: Chodosh
authors: John B
authors: JB
authors: Harley
authors: Pamela
authors: P
authors: Hughes
authors: Jacen S
authors: JS
authors: Maier-Moore
authors: Courtney G
authors: CG
authors: Montgomery
authors: Nelson L
authors: NL
authors: Rhodus
authors: A Darise
authors: AD
authors: Farris
authors: Barbara M
authors: BM
authors: Segal
authors: Roland
authors: R
authors: Jonsson
authors: Christopher J
authors: CJ
authors: Lessard
authors: R Hal
authors: RH
authors: Scofield
authors: Kathy L Moser
authors: KL
authors: Sivils
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult; D015331:Cohort Studies; D005060:Europe; D012859:Sjogren's Syndrome / Q000145:classification / Q000175:diagnosis / Q000235:genetics; D059467:Transcriptome; D014481:United States; D003245:Consensus Statements as Topic
keywords: Classification; Diagnosis; Sjögren's syndrome
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