Vasculitis & polymyalgia rheumatica
Performance of the 2022 American College of Rheumatology (ACR)/EULAR giant cell arteritis classification criteria for diagnosis in patients with suspected giant cell arteritis in routine clinical care
Authors' conclusion
The new 2022 ACR/EULAR GCA classification criteria showed adequate diagnostic accuracy in patients with suspected GCA under routine care, and an improvement on the sensitivity and specificity of the 1990 ACR classification criteria in all patient subsets.
Study context
- Population
- Patients with suspected giant cell arteritis (GCA) referred to two ultrasound (US) fast track clinics; GCA cases vs unselected controls with suspected GCA (mean age 76 years, 58.9% females)188 cases · 131 controls
- Participants
- 319 patients
- Comparison
- 2022 ACR/EULAR GCA classification criteria vs 1990 ACR criteria, against clinical diagnosis confirmed after 6 months of follow-up
- Outcome
- Diagnostic performance of the 2022 ACR/EULAR GCA classification criteria vs clinical confirmation of GCA
- Follow-up
- 6 months
Methodological detailsmulticentric, retrospective observational, two US fast track clinics
- Multicentric
- Retrospective observational
- Two US fast track clinics
Performance
As reported in the abstract
Diagnostic accuracy for GCA, overall
| Test or model | AUC | Sensitivity | Specificity |
|---|---|---|---|
| 2022 ACR/EULAR criteria | 0.928 (95% CI 0.899 to 0.957) | 92.6% | 71.8% |
| 1990 ACR criteria | — not stated in the abstract | 53.2% | 80.2% |
AUC
2022 ACR/EULAR criteria0.928 (95% CI 0.899 to 0.957)
1990 ACR criteria— not stated in the abstract
Sensitivity
2022 ACR/EULAR criteria92.6%
1990 ACR criteria53.2%
Specificity
2022 ACR/EULAR criteria71.8%
1990 ACR criteria80.2%
— not stated in the abstract
Further findings
- Overall performance of 1990 ACR criteria
- 53.2% · sensitivity · specificity 80.2%
- Performance of 2022 ACR/EULAR GCA criteria in disease subsets: Isolated large vessel-GCA sensitivity 62.2% · specificity 71.8% · AUC 0.691 (0.592 to 0.790)
- Performance of 2022 ACR/EULAR GCA criteria in disease subsets: Biopsy-proven GCA sensitivity 100% · specificity 71.8% · AUC 0.989 (0.976 to 1)
Original publication
Performance of the 2022 ACR/EULAR giant cell arteritis classification criteria for diagnosis in patients with suspected giant cell arteritis in routine clinical care. RMD Open. Published 24 April 2023. doi:10.
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