American College of Rheumatology

 【网址】 http://www.rheumatology.org 
【类型】 专业机构

美国风湿病学会（American College of Rheumatology,ACR）旨在利用教育、研究和实践支持项目为医生、健康专家和科学家们提供风湿 病学专业信息资源,最终实现推进风湿病学发展的目的。
 ACR通过举办风湿病学科学年会、专业会议和在线课程,为科研人员和临床医生提供继续深造的机会,每年秋季举办风湿病学领域最大规模 的科学年会,年会吸引成千上万名来自世界各地的风湿病学专家和关节炎健康专业人员参会。此外该学会举办的会议还有冬季的风湿病学专 题讨论会、春季的临床会议,以及其他专题会议等一系列以教育培训为目的的学术会议。
 ACR主办Arthritis and Rheumatism杂志,为风湿性疾病研究领域水平最高的学术期刊。风湿病健康专业协会（Association of Rheumatology Health Professionals,ARHP）作为ACR的一个子机构,主办Arthritis Care and Research,该机构是一个会员制协会,会 员包括风湿病学相关的专业医护人员,如高级护士、职业治疗师、理疗师等。
该学会主页提供了大量的信息资源,主要包括：
（1）实践管理（Practice Management）：包括临床实践管理、办公支持、实践管理快速链接等,其中以临床实践管理内容为主,信息主要 包括风湿病的临床支持信息,如参考书目、疾病分类和反应标准、患者健康状况评估、疾病活动度指数和损伤指数,实践指南等,同时还包 括风湿病专业人员实践标准、患者资源、质检及药品安全信息。
（2）出版物（Publications）：提供该学会主办的两种杂志的相关介绍、投稿指南、往期目录及网站链接;另外增加了学会的服务信息, 如药物安全性评价和最新消息、咨询热线;网站提供的会议资料和实践指南文件的下载只对其会员开放;值得一提的是该栏目中提供的风湿 病学图片库,收集了大量风湿病学相关图片,是风湿病学领域内容最全面的图片库,用户可以点击链接直接查看感兴趣的图片。
（3）教育和职业（Education &; Careers）：主要有年会和专业座谈会举办的时间、地点和主题等相关信息、课程大纲、上课时间及考试信 息等,除此之外,学会还提供了大量风湿病学相关资源和工具的链接,如图片库、医学知识自我评估模型、风湿病学编码手册等,方便用户 快速查阅所需内容;就业中心提供了工作岗位的信息介绍和应聘建议。
学会还为用户提供了大量风湿病学相关的法律知识、医改方案介绍、学会公开信等,设立了专门的立法行动中心,为用户提供全面的法律援 助;学会有自己的研究和教育基地,为临床医生、学生、健康专业人员、研究者和研究机构提供研究资金、培训和接受教育的机会。
（中国医科大学医学信息学系黄亚明潘现伟 整理）     

The American College of Rheumatology 1990 criteria for the classification of Wegener's granulomatosis

Criteria for the classification of Wegener's granulomatosis (WG) were developed by comparing 85 patients who had this disease with 722 control patients with other forms of vasculitis. For the traditional format classification, 4 criteria were selected: abnormal urinary sediment (red cell casts or greater than 5 red blood cells per high power field), abnormal findings on chest radiograph (nodules, cavities, or fixed infiltrates), oral ulcers or nasal discharge, and granulomatous inflammation on biopsy. The presence of 2 or more of these 4 criteria was associated with a sensitivity of 88.2% and a specificity of 92.0%. A classification tree was also constructed with 5 criteria being selected. These criteria were the same as for the traditional format, but included hemoptysis. The classification tree was associated with a sensitivity of 87.1% and a specificity of 93.6%. We describe criteria which distinguish patients with WG from patients with other forms of vasculitis with a high level of sensitivity and specificity. This distinction is important because WG requires cyclophosphamide therapy, whereas many other forms of vasculitis can be treated with corticosteroids alone.     

The American College of Rheumatology 1990 criteria for the classification of polyarteritis nodosa

Criteria for the classification of polyarteritis nodosa were developed by comparing 118 patients who had this disease with 689 control patients who had other forms of vasculitis. For the traditional format classification, 10 criteria were selected: weight loss greater than or equal to 4 kg, livedo reticularis, testicular pain or tenderness, myalgias, mononeuropathy or polyneuropathy, diastolic blood pressure greater than 90 mm Hg, elevated blood urea nitrogen or serum creatinine levels, presence of hepatitis B reactants in serum, arteriographic abnormality, and presence of granulocyte or mixed leukocyte infiltrate in an arterial wall on biopsy. The presence of 3 or more of these 10 criteria was associated with a sensitivity of 82.2% and specificity of 86.6%. A classification tree was also constructed, with 6 criteria being selected. Three of these, angiographic abnormality, biopsy-proven granulocyte or mixed leukocyte infiltrate in arterial wall, and neuropathy, were criteria used in the traditional format. The other 3 criteria used in the tree format included the patient's sex, weight loss greater than 6.5 kg, and elevated serum aspartate aminotransferase or alanine aminotransferase levels above the range of normal. The classification tree yielded a sensitivity of 87.3% and a specificity of 89.3%.     

The American College of Rheumatology 1990 criteria for the classification of hypersensitivity vasculitis

Criteria for the classification of hypersensitivity vasculitis were developed by comparing 93 patients who had this disease with 714 control patients with other forms of vasculitis. For the traditional format classification, 5 criteria were selected: age greater than 16 at disease onset, history of taking a medication at onset that may have been a precipitating factor, the presence of palpable purpura, the presence of maculopapular rash, and a biopsy demonstrating granulocytes around an arteriole or venule. The presence of 3 or more of these 5 criteria was associated with a sensitivity of 71.0% and a specificity of 83.9%. A classification tree was also constructed. The criteria appearing in the tree structure were the same as for the traditional format, except there were 2 pathology criteria: one required the presence of granulocytes in the wall of an arteriole or venule, and the other required the presence of eosinophils in the inflammatory exudate. The classification tree was associated with a sensitivity of 78.5% and a specificity of 78.7%.