Which Behçet Disease Classification Criteria Yields a More Accurate Diagnosis?

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The International Criteria for Behçet’s Disease (ICBD) can yield an earlier and more accurate diagnosis of Behçet disease (BD) than the BD criteria from the International Study Group (ISG), according to a new study released during the American College of Rheumatology’s (ACR) annual meeting, ACR Convergence.

“BD is a systemic, chronic, relapsing vasculitis with no pathognomonic diagnostic test. The most widely used classification criteria are those of the ISG for BD,” the researchers wrote. “These criteria were repeatedly found to have low sensitivity. Therefore, the ICBD were published in 2014.”

To compare the 2 sets of classification criteria, the researchers applied the criteria to 111 patients in a well-defined population in northern Spain who had been diagnosed with definitive or possible BD by expert rheumatologists between 1980 and 2019. The patients had a mean age of 36.8±13.2 years. A total of 62 patients were women and 49 were men.

In all, 65 patients (58.5%) were diagnosed with BD when the researchers applied the ISG criteria and 86 patients (77.5%) were diagnosed with BD when the researchers applied the ICBD criteria. Sensitivity was 58.6% for the ICBD criteria and 80.2% for the ISG criteria.

No significant differences were observed between the sets of criteria, and the overall concordance was deemed fair. 

“ICBD criteria exhibit higher sensitivity than ISG criteria,” the researchers concluded. “Thus, the application of these new criteria can achieve a more correct and earlier diagnosis of BD.”

—Colleen Murphy

Reference:

Martinez-Lopez D, Herrero Morant A, Alvarez-Reguera C, et al. Diagnosis of Behçet’s disease: comparison of two sets of classification criteria. Application in 111 patients of a well-defined population. Study presented at: American College of Rheumatology Convergence 2020; November 5-9, 2020; Virtual. Accessed October 29, 2020. https://acrabstracts.org/abstract/diagnosis-of-behcets-disease-comparison-of-two-sets-of-classification-criteria-application-in-111-patients-of-a-well-defined-population/