There is a need for new systemic sclerosis subset criteria. A content analytic approach

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Details zur Publikation

Autor(en): Johnson S, Soowamber M, Fransen J, Khanna D, Van Den Hoogen F, Baron M, Matucci-Cerinic M, Denton C, Medsger T, Carreira P, Riemekasten G, Distler J, Gabrielli A, Steen V, Chung L, Silver R, Varga J, Müller-Ladner U, Vonk M, Walker U, Wollheim F, Herrick A, Furst D, Czirjak L, Kowal-Bielecka O, Del Galdo F, Cutolo M, Hunzelmann N, Murray C, Foeldvari I, Mouthon L, Damjanov N, Kahaleh B, Frech T, Assassi S, Saketkoo L, Pope J
Zeitschrift: Scandinavian Journal of Rheumatology
Jahr der Veröffentlichung: 2017
Seitenbereich: 1-9
ISSN: 0300-9742


Systemic sclerosis (SSc) is heterogenous. The objectives of this study were to evaluate the purpose, strengths and limitations of existing SSc subset criteria, and identify ideas among experts about subsets.We conducted semi-structured interviews with randomly sampled international SSc experts. The interview transcripts underwent an iterative process with text deconstructed to single thought units until a saturated conceptual framework with coding was achieved and respondent occurrence tabulated. Serial cross-referential analyses of clusters were developed.Thirty experts from 13 countries were included; 67% were male, 63% were from Europe and 37% from North America; median experience of 22.5 years, with a median of 55 new SSc patients annually. Three thematic clusters regarding subsetting were identified: research and communication; management; and prognosis (prediction of internal organ involvement, survival). The strength of the limited/diffuse system was its ease of use, however 10% stated this system had marginal value. Shortcomings of the diffuse/limited classification were the risk of misclassification, predictions/generalizations did not always hold true, and that the elbow or knee threshold was arbitrary. Eighty-seven percent use more than 2 subsets including: SSc sine scleroderma, overlap conditions, antibody-determined subsets, speed of progression, and age of onset (juvenile, elderly).We have synthesized an international view of the construct of SSc subsets in the modern era. We found a number of factors underlying the construct of SSc subsets. Considerations for the next phase include rate of change and hierarchal clustering (e.g. limited/diffuse, then by antibodies).

FAU-Autoren / FAU-Herausgeber

Distler, Jörg PD Dr.
Heisenberg-Professur für Molekulare Mechanismen der Organfibrose

Autor(en) der externen Einrichtung(en)
Georgetown University
Hamburger Zentrum für Kinder- und Jugendrheumatologie
Hospital Universitario 12 de Octubre
McGill University
Medical University of Bialystok
Medical University of South Carolina (MUSC)
Northwestern University
Ospedale San Martino (IRCCS AOU)
Radboud university medical center / Radboudumc of voluit Radboud Universitair Medisch Centrum (UMC)
Royal Free Hospital
Skånes universitetssjukhus
Stanford University
Tulane University
Università degli Studi di Firenze / University of Florence
Università Politecnica delle Marche (UNIVPM)
Universität Köln
Universität Paris Descartes / Université Paris 5 René Descartes
Universitätsspital Basel
Universität zu Lübeck
University College London (UCL) (University of London)
University of Belgrade / Универзитет у Београду
University of California Los Angeles (UCLA)
University of Leeds
University of Manchester
University of Michigan
University of Pécs
University of Pittsburgh
University of Texas Health Science Center at Houston (UTHealth)
University of Toledo
University of Toronto
University of Utah
Western University


Johnson, S., Soowamber, M., Fransen, J., Khanna, D., Van Den Hoogen, F., Baron, M.,... Pope, J. (2017). There is a need for new systemic sclerosis subset criteria. A content analytic approach. Scandinavian Journal of Rheumatology, 1-9.

Johnson, S., et al. "There is a need for new systemic sclerosis subset criteria. A content analytic approach." Scandinavian Journal of Rheumatology (2017): 1-9.


Zuletzt aktualisiert 2018-08-10 um 08:26