OP0061 A Delphi exercise informing the development of criteria to measure response to treatment in giant cell arteritis
Notice bibliographique
Résumé
Background: The therapeutic landscape of giant cell arteritis (GCA) is growing rapidly but there are currently no internationally standardized criteria for assessing response to treatment in GCA. To address this gap, an international task force is working to develop such criteria. This project receives support from the European Alliance of Associations for Rheumatology (EULAR) and the American College of Rheumatology (ACR). Following a systematic literature review (SLR),[1] a Delphi exercise was conducted to determine items that might be included in the future response criteria. Objectives: To identify, through a Delphi exercise, the most important and relevant items to consider when developing criteria to measure response to treatment in GCA. Methods: A four-round web-based Delphi exercise was conducted. Participants from 38 countries included patients with GCA and physicians with expertise in GCA. Participants were asked to rate the importance (scale from 1-9; 1=lowest and 9=highest importance) of each of the 51 items identified from the SLR [1], grouped in six domains, and propose additional items they considered important to include. Items obtaining a score of 7-9 by at least 70% of physicians and 70% of patients were considered critically important and reached consensus. Items which scored 1-3 by 70% of physicians and patients were considered not important and excluded from subsequent rounds. In a ranking round (4th round), participants selected and ranked the 10 most relevant items from those deemed most important in the previous three rounds. Subsequently, a task force meeting was held where the results of the Delphi and ranking exercise were discussed, and items were selected for inclusion in the next phase of this project. Results: A total of 187 physicians and 85 patients participated in 4 rounds of the Delphi exercise. Of the task force members, 24/32 (75%) participated in the virtual task force meeting. Thirteen new items were proposed in round 1. Twenty-four items were rated as critically important (18 in round 1, 5 in round 2, 1 in round 3) by ≥70% of patients and ≥70% of physicians (Figure 1). These items covered the six domains of the Delphi (Figure 1): 10 for clinical, 2 for laboratory, 5 for imaging, 3 for treatment, 1 for patient-reported outcomes and 3 for damage. No items were excluded during any round, and consensus was not reached for 40 items. The top three highest-rated items by both patients and physicians were headache (ranked highest by 52% of patients and physicians), amaurosis fugax (ranked highest by 10%), and jaw claudication (ranked highest by 7%). Among the items discussed by the task force (Figure 1), glucocorticoid-related parameters were excluded as they were considered indirect indicators of response to treatment. Constitutional symptoms were added by the task force as they are important constellation of symptoms seen in GCA. The task force also decided to cluster items with similar constructs to capture the spectrum of the disease more concisely. For example, "GCA-related ischemic damage" was defined as capturing the spectrum of damage caused by GCA (e.g.: stroke, vision loss, scalp necrosis). 12 items were selected for the next phase of the project (Figure 2). Conclusion: This Delphi exercise identified the items and domains that experts and patients consider important and highly relevant for measuring response to treatment in GCA. These 12 items will be used in a subsequent group conjoint analysis to further prioritize and weigh potential items for inclusion in a draft set of criteria to measure treatment response in GCA. Figure 124 items regarding response to treatment in giant cell arteritis that reached consensus after 3 Delphi rounds. Figure 2The 12 items selected for the next step in developing criteria for response in giant cell arteritis: preliminary criteria and item weighting.GCA: giant cell arteritis. *Item selected by the task force, despite not reaching consensus in the Delphi exercise. REFERENCES: [1] Sanchez-Alvarez C et al. RMD Open 2023;9(2). Acknowledgements: NIL . Disclosure of Interests: Medha Soowamber AbbVie, AbbVie, Otsuka, Milena Bond Consultancy fees from Abbvie, Catalina Sanchez Alvarez: None declared, Carol Langford Grant support from Bristol-Myers Squibb, GlaxoSmithKline, AstraZeneca, Sibel Aydin Abbvie, Pfizer, Janssen, UCB, Novartis, Fresenius Kabi, Abbvie, Pfizer, Janssen, UCB, Eli Lilly, Novartis, Abbvie, Pfizer, Janssen, UCB, Eli Lilly, Novartis, Frank Buttgereit Abbvie, Grünenthal, Horizon Therapeutics, Novartis, Pfizer, Sanofi, Sparrow, Novartis, Abbvie, Sanofi, Abbvie, Almirall, Alexion, Amgen, Biogen, BMS, GSK, Hexal, Horizon Therapeutics, Lilly, Medac, Mundipharma, Novartis, Pfizer, Dario Camellino Astra-Zeneca, Boehringer Ingelheim, GSK, Janssen, Astra-Zeneca, Boehringer Ingelheim, GSK, Janssen, Maria C. Cid GSK, CSL-Vifor, AbbVie, Alexion, Boehringer-Ingelheim, AbbVie, GSK, CSL-Vifor, AstraZeneca, Novartis, Royalty Pharma, Kiniksa Pharmaceuticals LTd, Peter Grayson: None declared, Bernhard Hellmich Abbvie, Novartis, Abbvie, Novartis, Tanaz Kermani: None declared, Nader Khalidi Otsuka, GSK, Mallinckrodt, Roche, AbbVie, BMS, AbbVie, Sanofi, NS Pharma, Sarah Mackie Roche/Chugai, Vifor, Pfizer, UCB, Novartis, Fresenius Kabi and AbbVie, Roche/Chugai, Sanofi, AbbVie, AstraZeneca, Pfizer; Investigator on clinical trials for Sanofi, GSK, Sparrow, Alfred Mahr: None declared, Eric Matteson Boehringer Ingelheim, GmBH, Horizon Therapeutics, Amgen, Mehrdad Maz: None declared, Peter A Merkel AbbVie, Alpine, Amgen, ArGenx, AstraZeneca, Boeringher-Ingelheim, Bristol-Myers Squibb, CSL Behring, GlaxoSmithKline, HiBio, iCell, InflaRx, Janssen, Kinevant, Kyverna, Metagenomia, Novartis, NS Pharma, Q32, Regeneron, Sanofi, Sparrow, Takeda, Vistera, AbbVie, Amgen, AstraZeneca, Boeringher-Ingelheim, Bristol-Myers Squibb, Eicos, Electra, Forbius, Genentech/Roche, GlaxoSmithKline, InflaRx, Neutrolis, Takeda: Payments made to institution, Paul A Monach Boeringer-Ingelheim, Lorna Neill: None declared, Cristina Ponte Abbvie, GSK, Novartis, CSL Vifor, AstraZeneca, Abbvie, GSK, CSL Vifor, Roche, Carlo Salvarani Lilly, Abbvie, Johnson and Johnson, GSK, Novartis, CSL-Vifor, Boehringer-Ingelheim, Wolfgang Schmidt: None declared, Peter Villiger Roche, MSD, GSK, Vifor, AstraZeneca, Roche, Kenneth J Warrington Amgen, Amgen, Sanofi, Kiniksa, Eli Lilly, BMS: Clinical trial support to Mayo Clinic, Christian Dejaco Abbvie, Eli Lilly, Janssen, Galapagos, Novartis, Pfizer, Sparrow, Roche and Sanofi, Abbvie, Eli Lilly, Janssen, Galapagos, Novartis, Pfizer, Sparrow, Roche and Sanofi, AbbVie, Novartis, Sofia Ramiro AbbVie, Eli Lilly, Galapagos/Alfasigma, MSD, Novartis, Pfizer, UCB, Sanofi, AbbVie, Eli Lilly, Galapagos/Alfasigma, MSD, Novartis, Pfizer, UCB, Sanofi, AbbVie, Galapagos/Alfasigma, MSD, Novartis, Pfizer, UCB, Zahi Touma: None declared. © The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,196 | 0,171 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,002 |
| Bibliométrie | 0,003 | 0,002 |
| Études des sciences et des technologies | 0,005 | 0,005 |
| Communication savante | 0,003 | 0,004 |
| Science ouverte | 0,002 | 0,014 |
| Intégrité de la recherche | 0,003 | 0,005 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,011 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».