353cc35537ef91f11ee0f1bc336ed614 308607.pdf 1a3b68888c05955416a02c66363b7f0d8b2c4fbc 308607.pdf 4fc6b21ae4896f191b38689bd79b9a1a457a2f8fc4957ec957a643008e52067e 308607.pdf Title: Comparative Analysis of Classification Criteria in IgG4-Related Disease and Evaluating Diagnostic Accuracy from a Retrospective Cohort in Clinical Practice Subject: Introduction: We conducted a comprehensive comparative analysis of the Okazaki, Umehara, and American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria for diagnosing immunoglobulin G4-related disease (IgG4-RD). Materials and Methods: A retrospective study was conducted in a single tertiary hospital, using expert clinical judgment as the gold standard. We compared the diagnostic accuracy of the Okazaki, Umehara, and ACR/EULAR criteria in a cohort of 41 patients with suspected IgG4-RD. We assessed sensitivity, specificity, and positive and negative predictive values for each criterion, and conducted a separate analysis based on four IgG4-RD subtypes. Results: A total of 30 patients were confirmed to have IgG4-RD and 11 were identified as mimickers. The Umehara criteria demonstrated the highest sensitivity (83.33%), followed by the ACR/EULAR 2019 (66.67%) and Okazaki (60.0%) criteria. All three criteria exhibited 100% specificity, with overall diagnostic accuracy ranging from 70% to 88%. The areas under the curve (AUC) were 0.917 (Umehara), 0.800 (Okazaki), and 0.833 (ACR/EULAR 2019), indicating significant diagnostic effectiveness (p < 0.000). Subtype analysis revealed that the Umehara and ACR/EULAR 2019 criteria were more effective in diagnosing pancreato-hepato-biliary involvement (subtype 1), while the Okazaki and ACR/EULAR 2019 criteria were more effective in diagnosing retroperitoneal fibrosis and/or aortitis (subtype 2). Conclusions: Our study provides valuable insights into the diagnostic performance of the Okazaki, Umehara, and ACR/EULAR criteria for a cohort of patients with suspected IgG4-RD. The Umehara criterion demonstrated the highest sensitivity, suggesting its potential utility for screening purposes, while all three criteria showed consistent specificity. Keywords: IgG4; diagnostic criteria; ACR/EULAR Author: Marta Lopez-Gomez, Patricia Moya-Alvarado, Hye Sang Park, Mar Concepción Martín, Sara Calleja, Helena Codes-Mendez, Berta Magallares, Iván Castellví, Antonio J. Barros-Membrilla, Ana Laiz, César Diaz-Torné, Luis Sainz, Julia Bernárdez, Laura Martínez-Martinez and Hèctor Corominas Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Tue Nov 26 02:03:34 2024 CET ModDate: Tue Nov 26 02:08:11 2024 CET Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 18 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 540818 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- XYDCIJ+VnURWPalladioL-Bold Type 1 Custom yes yes yes 10 0 SMXYXO+URWPalladioL-Bold Type 1 Custom yes yes yes 16 0 XCQTCU+URWPalladioL-Roma Type 1 Custom yes yes yes 22 0 NLTAJC+URWPalladioL-Ital Type 1 Custom yes yes yes 27 0 HCRKXL+VnURWPalladioL Type 1 Custom yes yes yes 32 0 WRKAXN+CMSY10 Type 1 Builtin yes yes yes 68 0 QLBIEB+URWPalladioL-BoldItal Type 1 Custom yes yes yes 76 0 OOMOMN+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 100 0 OOMOMO+PalatinoLinotype CID TrueType Identity-H yes yes yes 103 0 OOMOMP+PalatinoLinotype TrueType WinAnsi yes yes no 109 0 OOMONB+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 112 0 OOMPEB+PalatinoLinotype TrueType MacRoman yes yes no 115 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2025-03-05 02:45:43 CET RepresentationInformation: 308607.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2025-03-04 19:15:28 CET Size: 540818 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 273 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Study Design and Setting Destination: subsection.2.1 Item: Title: Patients Destination: subsection.2.2 Item: Title: Procedures Destination: subsection.2.3 Item: Title: Statistical Analysis Destination: subsection.2.4 Item: Title: Results Destination: section.3 Children: Item: Title: General IgG4-RD Characteristics Destination: subsection.3.1 Item: Title: Okazaki, Umehara, and ACR/EULAR 2019 Criteria Destination: subsection.3.2 Item: Title: Description of IgG4-RD Subtypes Destination: subsection.3.3 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: Appendix A Destination: appendix.A. Item: Title: Appendix B Destination: appendix.B. Item: Title: Appendix C Destination: appendix.C. Item: Title: References Destination: appendix.D. Info: Title: Comparative Analysis of Classification Criteria in IgG4-Related Disease and Evaluating Diagnostic Accuracy from a Retrospective Cohort in Clinical Practice Author: Marta Lopez-Gomez, Patricia Moya-Alvarado, Hye Sang Park, Mar Concepción Martín, Sara Calleja, Helena Codes-Mendez, Berta Magallares, Iván Castellví, Antonio J. Barros-Membrilla, Ana Laiz, César Diaz-Torné, Luis Sainz, Julia Bernárdez, Laura Martínez-Martinez and Hèctor Corominas Subject: Introduction: We conducted a comprehensive comparative analysis of the Okazaki, Umehara, and American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria for diagnosing immunoglobulin G4-related disease (IgG4-RD). Materials and Methods: A retrospective study was conducted in a single tertiary hospital, using expert clinical judgment as the gold standard. We compared the diagnostic accuracy of the Okazaki, Umehara, and ACR/EULAR criteria in a cohort of 41 patients with suspected IgG4-RD. We assessed sensitivity, specificity, and positive and negative predictive values for each criterion, and conducted a separate analysis based on four IgG4-RD subtypes. Results: A total of 30 patients were confirmed to have IgG4-RD and 11 were identified as mimickers. The Umehara criteria demonstrated the highest sensitivity (83.33%), followed by the ACR/EULAR 2019 (66.67%) and Okazaki (60.0%) criteria. All three criteria exhibited 100% specificity, with overall diagnostic accuracy ranging from 70% to 88%. The areas under the curve (AUC) were 0.917 (Umehara), 0.800 (Okazaki), and 0.833 (ACR/EULAR 2019), indicating significant diagnostic effectiveness (p < 0.000). Subtype analysis revealed that the Umehara and ACR/EULAR 2019 criteria were more effective in diagnosing pancreato-hepato-biliary involvement (subtype 1), while the Okazaki and ACR/EULAR 2019 criteria were more effective in diagnosing retroperitoneal fibrosis and/or aortitis (subtype 2). Conclusions: Our study provides valuable insights into the diagnostic performance of the Okazaki, Umehara, and ACR/EULAR criteria for a cohort of patients with suspected IgG4-RD. The Umehara criterion demonstrated the highest sensitivity, suggesting its potential utility for screening purposes, while all three criteria showed consistent specificity. 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