Institution
American College of Rheumatology
Nonprofit•Atlanta, Georgia, United States•
About: American College of Rheumatology is a nonprofit organization based out in Atlanta, Georgia, United States. It is known for research contribution in the topics: Guideline & Population. The organization has 141 authors who have published 117 publications receiving 33521 citations.
Topics: Guideline, Population, Vasculitis, Rheumatology, Polyarteritis nodosa
Papers published on a yearly basis
Papers
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TL;DR: In 1992, Piette and colleagues suggested that the ACR revised criteria be reevaluated in light of the above discoveries, and the presence and clinical associations or antiphospholipid antibodies in patients with SLE was suggested.
Abstract: In 1982, the Diagnostic and Therapeutic Criteria Committee of the American College of Rheumatology (ACR)published revised criteria for the classification of systemiclupus erythematosus (SLE) (1). During the ensuing decade several investigators, including Drs. Graham Hughes and Donato Alarcon-Segovia, among others, have described the presence and clinical associations or antiphospholipid antibodies in patients with SLE, as well as the occurrence of theprimary antiphospholipid syndrome (2-5). In 1992, Piette and colleagues suggested that the ACR revised criteria be reevaluated in light of the above discoveries (6).
9,999 citations
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Boston University1, American College of Rheumatology2, University of Toronto3, Virginia Mason Medical Center4, McMaster University5, Food and Drug Administration6, University of Kentucky7, University of California, Los Angeles8, Stanford University9, Brigham and Women's Hospital10, University of Utah11
TL;DR: The results suggest that the definition of improvement presented is statistically powerful and does not identify a large percentage of placebo-treated patients as being improved, which the authors hope will be used widely in RA trials.
Abstract: Objective. Trials of rheumatoid arthritis (RA) treatments report the average response in multiple outcome measures for treated patients. It is more clinically relevant to test whether individual patients improve with treatment, and this identifies a single primary efficacy measure. Multiple definitions of improvement are currently in use in different trials. The goal of this study was to promulgate a single definition for use in RA trials.
Methods. Using the American College of Rheumatology (ACR) core set of outcome measures for RA trials, we tested 40 different definitions of improvement, using a 3-step process. First, we performed a survey of rheumatologists, using actual patient cases from trials, to evaluate which definitions corresponded best to rheumatologists' impressions of improvement, eliminating most candidate definitions of improvement. Second, we tested 20 remaining definitions to determine which maximally discriminated effective treatment from placebo treatment and also minimized placebo response rates. With 8 candidate definitions of improvement remaining, we tested to see which were easiest to use and were best in accord with rheumatologists' impressions of improvement.
Results. The following definition of improvement was selected: 20% improvement in tender and swollen joint counts and 20% improvement in 3 of the 5 remaining ACR core set measures: patient and physician global assessments, pain, disability, and an acutephase reactant. Additional validation of this definition was carried out in a comparative trial, and the results suggest that the definition is statistically powerful and does not identify a large percentage of placebo-treated patients as being improved.
Conclusion. We present a definition of improvement which we hope will be used widely in RA trials.
2,593 citations
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American College of Rheumatology1, Mayo Clinic2, Stanford University3, Johns Hopkins University4, University of Colorado Hospital5, Cleveland Clinic6, University of Calgary7, National Institutes of Health8, University of Kentucky9, University of Illinois at Chicago10, Harvard University11, SUNY Downstate Medical Center12, University of California, San Diego13
TL;DR: Criteria for the classification of giant cell (temporal) arteritis were developed by comparing 214 patients who had this disease with 593 patients with other forms of vasculitis, and 2 other variables were included: scalp tenderness and claudication of the jaw or tongue or on deglutition.
Abstract: Criteria for the classification of giant cell (temporal) arteritis were developed by comparing 214 patients who had this disease with 593 patients with other forms of vasculitis. For the traditional format classification, 5 criteria were selected: age greater than or equal to 50 years at disease onset, new onset of localized headache, temporal artery tenderness or decreased temporal artery pulse, elevated erythrocyte sedimentation rate (Westergren) greater than or equal to 50 mm/hour, and biopsy sample including an artery, showing necrotizing arteritis, characterized by a predominance of mononuclear cell infiltrates or a granulomatous process with multinucleated giant cells. The presence of 3 or more of these 5 criteria was associated with a sensitivity of 93.5% and a specificity of 91.2%. A classification tree was also constructed using 6 criteria. These criteria were the same as for the traditional format, except that elevated erythrocyte sedimentation rate was excluded, and 2 other variables were included: scalp tenderness and claudication of the jaw or tongue or on deglutition. The classification tree was associated with a sensitivity of 95.3% and specificity of 90.7%.
2,204 citations
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University of Alabama at Birmingham1, American University of Beirut2, Tufts Medical Center3, Beth Israel Deaconess Medical Center4, University of California, Los Angeles5, Washington University in St. Louis6, University of California, San Diego7, University of Nebraska Medical Center8, Mayo Clinic9, University of Minnesota10, NorthShore University HealthSystem11, Duke University12, American College of Rheumatology13
TL;DR: To develop a new evidence‐based, pharmacologic treatment guideline for rheumatoid arthritis (RA), a large number of patients with RA are referred to a single clinic for treatment with these medications.
Abstract: Objective
To develop a new evidence-based, pharmacologic treatment guideline for rheumatoid arthritis (RA).
Methods
We conducted systematic reviews to synthesize the evidence for the benefits and harms of various treatment options. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to rate the quality of evidence. We employed a group consensus process to grade the strength of recommendations (either strong or conditional). A strong recommendation indicates that clinicians are certain that the benefits of an intervention far outweigh the harms (or vice versa). A conditional recommendation denotes uncertainty over the balance of benefits and harms and/or more significant variability in patient values and preferences.
Results
The guideline covers the use of traditional disease-modifying antirheumatic drugs (DMARDs), biologic agents, tofacitinib, and glucocorticoids in early (<6 months) and established (≥6 months) RA. In addition, it provides recommendations on using a treat-to-target approach, tapering and discontinuing medications, and the use of biologic agents and DMARDs in patients with hepatitis, congestive heart failure, malignancy, and serious infections. The guideline addresses the use of vaccines in patients starting/receiving DMARDs or biologic agents, screening for tuberculosis in patients starting/receiving biologic agents or tofacitinib, and laboratory monitoring for traditional DMARDs. The guideline includes 74 recommendations: 23% are strong and 77% are conditional.
Conclusion
This RA guideline should serve as a tool for clinicians and patients (our two target audiences) for pharmacologic treatment decisions in commonly encountered clinical situations. These recommendations are not prescriptive, and the treatment decisions should be made by physicians and patients through a shared decision-making process taking into account patients’ values, preferences, and comorbidities. These recommendations should not be used to limit or deny access to therapies.
2,083 citations
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American College of Rheumatology1, University of Illinois at Chicago2, Mayo Clinic3, Stanford University4, University of Colorado Hospital5, Cleveland Clinic6, University of Calgary7, National Institutes of Health8, University of Kentucky9, Harvard University10, Johns Hopkins University11, University of California, San Diego12
TL;DR: Criteria for the classification of Churg-Strauss syndrome were developed by comparing 20 patients who had this diagnosis with 787 control patients with other forms of vasculitis, and advantages of the traditional format compared with the classification tree format are discussed.
Abstract: Criteria for the classification of Churg-Strauss syndrome (CSS) were developed by comparing 20 patients who had this diagnosis with 787 control patients with other forms of vasculitis. For the traditional format classification, 6 criteria were selected: asthma, eosinophilia greater than 10% on differential white blood cell count, mononeuropathy (including multiplex) or polyneuropathy, non-fixed pulmonary infiltrates on roentgenography, paranasal sinus abnormality, and biopsy containing a blood vessel with extravascular eosinophils. The presence of 4 or more of these 6 criteria yielded a sensitivity of 85% and a specificity of 99.7%. A classification tree was also constructed with 3 selected criteria: asthma, eosinophilia greater than 10% on differential white blood cell count, and history of documented allergy other than asthma or drug sensitivity. If a subject has eosinophilia and a documented history of either asthma or allergy, then that subject is classified as having CSS. For the tree classification, the sensitivity was 95% and the specificity was 99.2%. Advantages of the traditional format compared with the classification tree format, when applied to patients with systemic vasculitis, and their comparison with earlier work on CSS are discussed.
1,954 citations
Authors
Showing all 142 results
Name | H-index | Papers | Citations |
---|---|---|---|
Anthony S. Fauci | 185 | 960 | 133535 |
David T. Felson | 153 | 861 | 133514 |
Peter Tugwell | 129 | 948 | 125480 |
Marc C. Hochberg | 127 | 691 | 87268 |
Frederick Wolfe | 119 | 417 | 101272 |
Daniel E. Furst | 109 | 643 | 59748 |
Daniel H. Solomon | 100 | 623 | 38921 |
Claire Bombardier | 100 | 295 | 61805 |
James F. Fries | 100 | 369 | 83589 |
Theodore Pincus | 97 | 420 | 46012 |
Elie A. Akl | 95 | 482 | 58031 |
Matthew H. Liang | 93 | 339 | 53685 |
Sherine E. Gabriel | 91 | 273 | 63492 |
Michael E. Weinblatt | 86 | 455 | 44442 |
Gene G. Hunder | 86 | 244 | 61920 |