Identifying Potential Classification Criteria for Calcium Pyrophosphate Deposition Disease: Item Generation and Item Reduction.

Sara K Tedeschi, Tristan Pascart, Augustin Latourte, Cattleya Godsave, Burak Kundakci, Raymond P Naden, William J Taylor, Nicola Dalbeth, Tuhina Neogi, Fernando Perez-Ruiz, Ann Rosenthal, Fabio Becce, Eliseo Pascual, Mariano Andres, Thomas Bardin, Michael Doherty, Hang-Korng Ea, Georgios Filippou, John FitzGerald, Marwin Guitierrez, Annamaria Iagnocco, Tim L Jansen, Minna J Kohler, Frédéric Lioté, Mark Matza, Geraldine M McCarthy, Roberta Ramonda, Anthony M Reginato, Pascal Richette, Jasvinder A Singh, Francisca Sivera, Alexander So, Lisa K Stamp, Janeth Yinh, Chio Yokose, Robert Terkeltaub, Hyon Choi, Abhishek Abhishek

Journal: Arthritis care & research 2022;74(10):1649-1658

PMID: 33973414

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Abstract

OBJECTIVE

Classification criteria for calcium pyrophosphate deposition (CPPD) disease will facilitate clinical research on this common crystalline arthritis. Our objective was to report on the first 2 phases of a 4-phase process for developing CPPD classification criteria.

METHODS

CPPD classification criteria development is overseen by a 12-member steering committee. Item generation (phase I) included a scoping literature review of 5 literature databases and contributions from a 35-member combined expert committee and 2 patient research partners. Item reduction and refinement (phase II) involved a combined expert committee meeting, discussions among clinical, imaging, and laboratory advisory groups, and an item-rating exercise to assess the influence of individual items toward classification. The steering committee reviewed the modal rating score for each item (range -3 [strongly pushes away from CPPD] to +3 [strongly pushes toward CPPD]) to determine items to retain for future phases of criteria development.

RESULTS

Item generation yielded 420 items (312 from the literature, 108 from experts/patients). The advisory groups eliminated items that they agreed were unlikely to distinguish between CPPD and other forms of arthritis, yielding 127 items for the item-rating exercise. Fifty-six items, most of which had a modal rating of +/- 2 or 3, were retained for future phases. As numerous imaging items were rated +3, the steering committee recommended focusing on imaging of the knee and wrist and 1 additional affected joint for calcification suggestive of CPP crystal deposition.

CONCLUSION

A data- and expert-driven process is underway to develop CPPD classification criteria. Candidate items comprise clinical, imaging, and laboratory features.

Address: Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.; Lille Catholic University, Lille, France.; Hôpital Lariboisière, Université de Paris, Paris, France.; University of Nottingham, Nottingham, UK.; University of Otago, Wellington, New Zealand.; University of Auckland, Auckland, New Zealand.; Boston University School of Medicine, Boston, Massachusetts.; Osakidetza, Ezkerraldea-Enkarterri-Cruces, Cruces University Hospital, Biocruces-Bizkaia Health Research Institute, and University of the Basque Country, Spain.; Medical College of Wisconsin, Milwaukee.; Lausanne University Hospital, Lausanne, Switzerland.; Hospital General Universitario de Alicante and Alicante Institute of Sanitary and Biomedical Research, Alicante, Spain.; Luigi Sacco University Hospital, Milan, Italy.; David Geffen School of Medicine, University of California, Los Angeles.; Instituto Nacional de Rehabilitación, Mexico City, Mexico.; Università degli Studi di Torino, Turin, Italy.; VieCuri Medical Center, Venlo, Noord-Limburg, and University of Twente, Enschede, The Netherlands.; Massachusetts General Hospital and Harvard Medical School, Boston.; Mater Misericordiae University Hospital, Dublin, Ireland.; University of Padova, Padova, Italy.; Brown University, Providence, Rhode Island.; University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center.; Hospital General Universitario Elda, Elda, and Universidad Miguel Hernandez, Elche, Spain.; University of Otago, Christchurch, New Zealand.; San Diego Veterans Administration Healthcare Service and University of California-San Diego.

DOI: 10.1002/acr.24619