Sensitivity and specificity of different diagnostic criteria for Behçet's disease according to the latent class approach.

In this study, we estimated the sensitivity and specificity of different criteria (International, Japanese, Mason & Barnes, O'Duffy, James and clinical judgement) for Behçet's Disease using the latent class approach. Thirty-two consecutive Behçet's Disease patients who were initially diagnosed according to clinical judgement, and 56 control patients with other rheumatic diseases, were recruited from the rheumatology out-patient clinic. The patients had their charts reviewed, were interviewed and clinically examined. Various models including different combinations of the six diagnostic criteria were tested. In the model that included all the information gathered, the International (sensitivity = 0.95, specificity = 1.00), Japanese (sensitivity = 1.00, specificity - 0.95) and Mason & Barnes criteria (sensitivity = 1.00, specificity = 0.94) were the most accurate. Clinician judgement also performed very well in identifying a Behçet's Disease case (sensitivity = 1.00, specificity = 0.85). The International, Japanese and Mason & Barnes criteria were the most accurate. The latent class method led to these conclusions without making any initial assumptions about the accuracy of any of the competing criteria (including clinical judgement).

EPM-ROM Scale: an evaluative instrument to be used in rheumatoid arthritis trials.

Different tools are available for the measurement of functional status; however, only a few of them are based on the evaluation of the joint range of motion (ROM). This study is aimed at the design and evaluation of the measurement properties of a ROM scale to be used as an evaluative instrument in rheumatoid arthritis (RA) trials. The EPM-ROM Scale evaluates 10 distinct movements of the small and large joints. The score of each joint varies from 0 (full movement) to 3 (severe limitation) and the cut-off degrees of motion are, in general, based on the lack of ability to perform some determined activities of daily living. The test-retest characteristic of the scale was assessed by administering the scale twice, 5 days apart, to 35 RA patients. The product moment correlation was 0.775 (P less than 0.001). The cross-sectional construct validity of the scale was assessed by the concomitant scoring of the EPM-ROM Scale and the functional ability dimension of the Health Assessment Questionnaire (a reliable, valid and responsive instrument) in these patients. The product moment correlation was 0.518 (P less than 0.001). The evaluation of its longitudinal construct validity and responsiveness are now in progress.

Variola minor in Braganca Paulista County, 1956: household aggregation of the disease and the influence of household size on the attack rate.

Household aggregation of cases, one possible characteristic of person-to-person transmitted disease, was formally tested in one epidemic of variola minor by using a pair statistic. A significant result was found for all households as well as for households grouped by the type of environment, or by the phase of the epidemic growth in time. Secondary attack rates, when related to household size (number of susceptibles) showed only a marginal trend in rural households but no trend in urban or semi-rural households.