|Title:||Comparison and validation of International Consensus Diagnostic Criteria for diagnosis of autoimmune pancreatitis from pancreatic cancer in a Taiwanese cohort||Authors:||MING-CHU CHANG
|Issue Date:||2014||Journal Volume:||4||Journal Issue:||8||Source:||BMJ Open||Abstract:||
Objectives: The International Consensus Diagnostic Criteria (ICDC) designed to diagnosis autoimmune pancreatitis (AIP) has been proposed recently. The diagnostic performance of ICDC has not been previously evaluated in diffuse-type and focal-type AIP, respectively, in comparison with the revised HISORt and Asian criteria in Taiwan. Design: Prospective, consecutive patient cohort. Setting: Largest tertiary referred centre hospital managing pancreatic disease in Taiwan. Participants: 188 patients with AIP and 130 with tissue proofed pancreatic adenocarcinoma were consecutively recruited. Interventions: The ICDC, as well as revised HISORt and Asian criteria, was applied for each participant. Each diagnostic criterion of ICDC was validated with special reference to levels 1 and 2 in diffuse-type and focal-type AIP. Outcomes: Sensitivity, specificity and accuracy. Each diagnostic criterion of ICDC was validated with special reference to levels 1 and 2 in AIP and focal-type AIP. Results: The sensitivity, specificity and accuracy of ICDC for all AIP were the best: 89.4%, 100% and 93.7%, respectively, in these three criteria. The sensitivity, specificity and accuracy of ICDC for focal-type AIP (84.9%, 100% and 93.8%) were also the best among these three criteria. The area under the curve of receiver-operator characteristic of ICDC was 0.95 (95% CI 0.92 to 0.97) in all AIP and 0.93 (95% CI 0.88 to 0.97) in focal-type AIP. Conclusions: The sensitivity, specificity and accuracy of ICDC are higher than the revised HISORt and Asian criteria. The sensitivity, specificity and accuracy of each criterion are higher in diffuse-type AIP compared with focal-type AIP. Under the same specificity, the sensitivity and accuracy of ICDC are higher than other diagnostic criteria in focal-type AIP. ICDC has better diagnostic performance compared with previously proposed diagnostic criteria in diffuse-type and focal-type AIP.
|ISSN:||2044-6055||DOI:||10.1136/bmjopen-2014-005900||SDG/Keyword:||immunoglobulin G4; steroid; adult; aged; area under the curve; article; autoimmune pancreatitis; cholestasis; comparative study; diagnostic accuracy; diagnostic test accuracy study; drug response; drug withdrawal; female; follow up; histology; human; immunoglobulin blood level; international consensus diagnostic criteria; lacrimal gland; major clinical study; male; named inventories, questionnaires and rating scales; pancreas; pancreas adenocarcinoma; pancreas disease; prospective study; receiver operating characteristic; salivary gland; sensitivity and specificity; serology; steroid therapy; Taiwan; treatment response; validation study; adenocarcinoma; Autoimmune Diseases; consensus; differential diagnosis; middle aged; Pancreatic Neoplasms; pancreatitis; Adenocarcinoma; Adult; Aged; Area Under Curve; Autoimmune Diseases; Consensus; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Pancreatic Neoplasms; Pancreatitis; Prospective Studies; ROC Curve; Sensitivity and Specificity
|Appears in Collections:||醫學系|
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