title: A comparative study of diagnostic scoring systems for autoimmune pancreatitis.
abstract: OBJECTIVE
  Several diagnostic scoring systems for autoimmune pancreatitis (AIP) have been proposed including the Asian, HISORt (Histology, Imaging, Serology, Other organ involvement and Response to therapy), and International Consensus Diagnostic Criteria (ICDC), which have been compared by a few studies. We evaluated the diagnostic performance of these criteria in patients diagnosed with AIP between May 1992 and August 2011.
  
  
  METHODS
  Scoring systems were applied retrospectively using data obtained in the initial evaluation period, before pancreatic resection was performed.
  
  
  RESULTS
  One hundred fourteen cases with AIP were included. Eighty-two percent met the diagnostic criteria for AIP according to either the Asian, HISORt, or ICDC criteria. Only 33% met the Asian criteria, probably mainly related to a low rate of diagnostic pancreatography. In 18%, all scoring systems failed to confirm the diagnosis, even though these patients were considered to have a firm diagnosis of AIP.
  
  
  CONCLUSIONS
  In this cohort of AIP patients, the 3 major diagnostic scoring systems for AIP proved to be complementary rather than overlapping. Our data indicate that one-fifth of our AIP patients do not meet any of these scoring systems. The ICDC, Asian, and HISORt criteria should be considered as useful clinical tools but not as criterion standard for the diagnosis.
authors.affiliation: From the *Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam; †Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam; ‡Department of Pathology, Erasmus University Medical Center; and §Department of Pathology, Academic Medical Center, Amsterdam; ∥Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht; and ¶Department of Gastroenterology and Hepatology, Meander Medical Center, Amersfoort, the Netherlands.
authors.forename: Marianne J
authors.initials: MJ
authors.lastname: van Heerde
authors.forename: Jorie
authors.initials: J
authors.lastname: Buijs
authors.forename: Erik A
authors.initials: EA
authors.lastname: Rauws
authors.forename: Lucas J Maillette
authors.initials: LJ
authors.lastname: de Buy Wenniger
authors.forename: Bettina E
authors.initials: BE
authors.lastname: Hansen
authors.forename: Katharina
authors.initials: K
authors.lastname: Biermann
authors.forename: Joanne
authors.initials: J
authors.lastname: Verheij
authors.forename: Frank P
authors.initials: FP
authors.lastname: Vleggaar
authors.forename: Menno A
authors.initials: MA
authors.lastname: Brink
authors.forename: Ulrich H W
authors.initials: UH
authors.lastname: Beuers
authors.forename: Ernst J
authors.initials: EJ
authors.lastname: Kuipers
authors.forename: Henk R
authors.initials: HR
authors.lastname: van Buuren
authors.forename: Marco J
authors.initials: MJ
authors.lastname: Bruno
mesh_terms: D000368:Aged; D001327:Autoimmune Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D011237:Predictive Value of Tests; D011379:Prognosis; D011859:Radiography; D012189:Retrospective Studies; D012720:Severity of Illness Index