Need For Classification Criteria Research Articles

Disease characteristics, pathogenesis, and treatment controversies of axial psoriatic arthritis

Axial psoriatic arthritis (axPsA) has considerable overlap with axial spondyloarthritis (axSpA) but has some unique features that sometimes preclude classification into axSpA. It has some clinical and radiographic differences compared to axSpA. Imaging typically shows asymmetric syndesmophytes, mainly in the cervical spine, with less frequent sacroiliitis. It more commonly presents later in life and is associated with less severe inflammatory back pain than axSpA. The interleukin (IL) IL-23/IL-17 axis is central to the pathogenesis of both diseases. However, the response to therapies targeting these cytokines has been different. IL-23 inhibitors are ineffective in axSpA but may be effective in psoriatic arthritis (PsA). Recent post hoc analyses of clinical trial data with IL-23 inhibitors in PsA have raised the possibility of their efficacy in axPsA and need evaluation in future clinical trials. Moreover, there is a need for classification criteria for axPsA and better tools to assess therapeutic response.

On the need for classification criteria for cast in situ RC beam–column joints according to their stiffness

The purpose of this paper is to draw attention to the lack, in current technical specifications, (i) of guidelines on the modelling of cast in situ reinforced concrete beam–column (RCBC) joints and, more specifically, (ii) for a given RCBC joint, of simplified procedures for evaluating if the fully rigid joint model is acceptable or not, having in view its effective stiffness. This is an important issue because, even though it is widely recognized that RCBC joints are a major source of deformation of cast in situ unbraced RC frames, there is no acknowledged simple procedure to assess the relevance of joint flexibility to the overall structural behaviour—as a consequence, the fully rigid joint model is commonly used without any reference to joint stiffness minimum required values. On the other hand, for steel frames, classification criteria for joints according to their stiffness have already been developed. This paper (i) shows that EN 1993-1-8: 2005 simplified classification criteria for steel joints according to their stiffness are inadequate for cast in situ RCBC joints, (ii) develops a modified version of these criteria, appropriate only for very particular conditions, which maintains their basic hypotheses but considers the specificities of RCBC joints and frames and (iii) in agreement with recently published results, concludes that, in some cases, RCBC joints should not be considered nominally rigid and thus their flexibility should be explicitly accounted for in the analysis of unbraced RC frames. The developed simplified classification criteria apply only to very particular cases—some guidance is therefore also provided on the development of general simplified classification criteria for RCBC joints.

Update on the classification of vasculitis

Classification criteria have an important role and practical use in everyday rheumatology. Improvement in therapy and our understanding of the aetiopathogenesis of vasculitis have driven the need to have better descriptors and groupings of diseases. This in turn will allow newer therapy and further understanding to have a greater impact. The American College of Rheumatology (ACR) classification criteria have been an important advance but have limitations. There remains confusion between classification and diagnostic criteria and definitions. We hope to resolve this using evidence-based improvements in classification and diagnostic criteria. Further understanding of the underlying causative mechanisms could lead to diagnostic testing, eliminating the need for classification criteria.