Behçet's disease classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2]

Overview

There is no established system for the classification of [disease name].

OR

[Disease name] may be classified according to [classification method] into [number] subtypes/groups: [group1], [group2], [group3], and [group4].

OR

[Disease name] may be classified into [large number > 6] subtypes based on [classification method 1], [classification method 2], and [classification method 3]. [Disease name] may be classified into several subtypes based on [classification method 1], [classification method 2], and [classification method 3].

OR

Based on the duration of symptoms, [disease name] may be classified as either acute or chronic.

OR

If the staging system involves specific and characteristic findings and features: According to the [staging system + reference], there are [number] stages of [malignancy name] based on the [finding1], [finding2], and [finding3]. Each stage is assigned a [letter/number1] and a [letter/number2] that designate the [feature1] and [feature2].

OR

The staging of [malignancy name] is based on the [staging system].

OR

There is no established system for the staging of [malignancy name].

Several diagnostic and classification criteria have been developed for Behçet syndrome. Like other sets of criteria, these were developed to categorize patients for study purposes and were not developed to diagnose disease in individuals [25,107,108]. It has been suggested that their accuracy is better in populations with low prevalence than in those with high [108].

As mentioned above, we prefer the International Study Group (ISG) diagnostic criteria published in 1990 (table 2) [25]. These criteria appear to be relatively sensitive and specific [106,109]. As an example, in one report of 32 clinically diagnosed patients with Behçet syndrome and 56 controls with other rheumatic diseases, the sensitivity and specificity were 95 and 100 percent, respectively [106]. Crohn disease, ulcerative colitis, and familial Mediterranean fever share some clinical manifestations with Behçet syndrome. Including patients with these disorders among controls did not lead to substantially different sensitivity of specificity of the criteria [110].

The International Criteria for Behçet's disease (ICBD) were developed in 2006 in an effort to improve sensitivity compared with the ISG criteria, but they are not widely accepted [111]. Each of several findings is assigned a point value; the criteria require a total of at least three points for diagnosis of Behçet syndrome:

●Genital aphthosis – Two points

●Ocular lesions (anterior uveitis, posterior uveitis, or retinal vasculitis) – Two points

●Oral aphthosis – One point

●Skin lesions (pseudofolliculitis or erythema nodosum) – One point

●Vascular lesions (superficial phlebitis, deep vein thrombosis, large vein thrombosis, arterial thrombosis, or aneurysm) – One point

●Pathergy – One point

Validation studies have estimated a sensitivity of 87 to 96.5 percent, a specificity of 88.9 to 97.3 percent, and an accuracy of 74.2 to 85.5 percent for these criteria [112].

Classification

• There is no established system for the classification of [disease name].

OR

• [Disease name] may be classified according to [classification method] into [number] subtypes/groups:
  • [Group1]
  • [Group2]
  • [Group3]
  • [Group4]

OR

• [Disease name] may be classified into [large number > 6] subtypes based on:
  • [Classification method 1]
  • [Classification method 2]
  • [Classification method 3]
• [Disease name] may be classified into several subtypes based on:
  • [Classification method 1]
  • [Classification method 2]
  • [Classification method 3]

OR

• Based on the duration of symptoms, [disease name] may be classified as either acute or chronic.

OR

• If the staging system involves specific and characteristic findings and features:
• According to the [staging system + reference], there are [number] stages of [malignancy name] based on the [finding1], [finding2], and [finding3]. Each stage is assigned a [letter/number1] and a [letter/number2] that designate the [feature1] and [feature2].

OR

• The staging of [malignancy name] is based on the [staging system].

OR

• There is no established system for the staging of [malignancy name].