{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T21:15:42Z","timestamp":1771103742412,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2005,11,29]],"date-time":"2005-11-29T00:00:00Z","timestamp":1133222400000},"content-version":"vor","delay-in-days":6298,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis &amp; Rheumatism"],"published-print":{"date-parts":[[1988,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>We investigated diagnostic testing in polyarteritis nodosa (PAN) by calculating, from published data, the sensitivity and specificity of visceral angiography and muscle, nerve, testicle, kidney, and liver biopsy. Test sequence strategies were constructed by Bayesian inference using a computer program written for this purpose. Test sequences were compared with an aggressive strategy consisting of repeated tests until there was a positive finding or until the available tests were exhausted, and a conservative strategy consisting of 1 biopsy procedure plus angiography. The Bayesian analysis agreed most closely with the conservative approach for most prior probabilities (degree of suspicion) that a patient had PAN. The aggressive strategy had an overall sensitivity of 90% and specificity of 91%, whereas the conservative strategy was 85% sensitive and 96% specific. Furthermore, the aggressive strategy was more costly ($2,986 versus $1,961) and had a higher rate of morbidity (3.8 versus 2.7 days of hospitalization per patient evaluated) than did the conservative strategy. The mortality rates of both strategies were equivalent (\u223c0.05 deaths per hundred patients evaluated). The per\u2010case cost of diagnosis increased as prevalence decreased, and at 10% prevalence, the aggressive strategy cost more than $17,000 per case diagnosed. Sensitivity analysis revealed that the strategies were moderately affected by the test characteristics, within reasonable assumptions, but that the differences in conservative and aggressive approaches remained. Thus, our analysis based on available data and the assumption of test independence suggests that the preferred diagnostic evaluation of patients with symptoms suggestive of PAN consists, in most cases, of a single biopsy procedure, with angiographic evaluation if necessary.<\/jats:p>","DOI":"10.1002\/art.1780310906","type":"journal-article","created":{"date-parts":[[2007,2,14]],"date-time":"2007-02-14T22:19:00Z","timestamp":1171491540000},"page":"1117-1127","source":"Crossref","is-referenced-by-count":59,"title":["The diagnosis of polyarteritis nodosa"],"prefix":"10.1002","volume":"31","author":[{"given":"Daniel A.","family":"Albert","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Rimon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc D.","family":"Silverstein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2005,11,29]]},"reference":[{"key":"e_1_2_1_2_2","volume-title":"Systemic necrotizing vasculitis of the polyarteritis nodosa group, The Vasculitides","author":"Cupps TR","year":"1981"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198005153022003"},{"key":"e_1_2_1_4_2","first-page":"461","article-title":"Necrotizing angiopathic neuropathy","volume":"47","author":"Dyck PJ","year":"1972","journal-title":"Mayo Clin Proc"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0049-0172(79)80007-4"},{"key":"e_1_2_1_6_2","first-page":"505","article-title":"L'arteriographie dans la periarterite noueuse: a propos de 15 cas","volume":"57","author":"D'Izarn JJ","year":"1976","journal-title":"J Radiol Electrol"},{"key":"e_1_2_1_7_2","first-page":"113","article-title":"L'arteriographie dans la periarterite noueuse","volume":"60","author":"Chatel A","year":"1979","journal-title":"J Radiol"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/000331978103201105"},{"key":"e_1_2_1_9_2","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1016\/S0039-6109(16)33704-5","article-title":"Muscle biopsy in the diagnosis of periarteritis nodosa","volume":"32","author":"Maxeiner SR","year":"1952","journal-title":"Surg Clin North Am"},{"key":"e_1_2_1_10_2","first-page":"411","article-title":"Prognostic factors in polyarteritis","volume":"2","author":"Sack M","year":"1975","journal-title":"J Rheumatol"},{"key":"e_1_2_1_11_2","first-page":"237","article-title":"Neurological features of polyarteritis nodosa","volume":"15","author":"Walker GL","year":"1978","journal-title":"Clin Exp Neurol"},{"key":"e_1_2_1_12_2","first-page":"146","article-title":"Clinical features, prognosis, and response to treatment in polyarteritis","volume":"55","author":"Cohen RD","year":"1980","journal-title":"Mayo Clin Proc"},{"key":"e_1_2_1_13_2","first-page":"511","article-title":"Immunologic mechanisms in systemic vasculitis","volume":"51","author":"Conn DL","year":"1976","journal-title":"Mayo Clin Proc"},{"key":"e_1_2_1_14_2","first-page":"634","article-title":"Diagnostic and therapeutic problems of polyarteritis nodosa","volume":"56","author":"Keeton GR","year":"1979","journal-title":"S Afr Med J"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-40-6-1145"},{"key":"e_1_2_1_16_2","volume-title":"Clinical Decision Analysis","author":"Weinstein ML","year":"1980"},{"key":"e_1_2_1_17_2","doi-asserted-by":"publisher","DOI":"10.1148\/81.2.257"},{"key":"e_1_2_1_18_2","first-page":"918","article-title":"Percutaneous transfemoral arteriography","volume":"92","author":"Halpern M","year":"1964","journal-title":"AJR"},{"key":"e_1_2_1_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-196602000-00009"},{"key":"e_1_2_1_20_2","first-page":"594","article-title":"Complication rates of transfemoral and transaortic catheterization","volume":"63","author":"Haut G","year":"1968","journal-title":"Surgery"},{"key":"e_1_2_1_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)64898-5"},{"key":"e_1_2_1_22_2","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1542\/peds.30.2.287","article-title":"Percutaneous renal biopsy in children","volume":"30","author":"Dodge WF","year":"1962","journal-title":"Pediatrics"},{"key":"e_1_2_1_23_2","first-page":"924","article-title":"Das Risiko der perkutanen Leberbiopsie","volume":"66","author":"Linder H","year":"1971","journal-title":"Med Klin"},{"key":"e_1_2_1_24_2","first-page":"533","article-title":"Uber Vorteil und Risiko der Leberbiopsieme\u2010thode nach Menghini","volume":"76","author":"Thaler H","year":"1964","journal-title":"Wien Klin Wochenschr"},{"key":"e_1_2_1_25_2","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X8300300108"},{"key":"e_1_2_1_26_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197810262991705"},{"key":"e_1_2_1_27_2","volume-title":"The epidemiology of systemic arteritis, Epidemiology of Rheumatic Diseases","author":"Kurland LT","year":"1984"},{"key":"e_1_2_1_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(81)90195-9"},{"key":"e_1_2_1_29_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1954.00250060076007"},{"key":"e_1_2_1_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(60)90185-6"},{"key":"e_1_2_1_31_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197507312930502"},{"key":"e_1_2_1_32_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780310907"}],"container-title":["Arthritis &amp; Rheumatism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fart.1780310906","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/art.1780310906","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,23]],"date-time":"2023-11-23T16:57:51Z","timestamp":1700758671000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/art.1780310906"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1988,9]]},"references-count":31,"journal-issue":{"issue":"9","published-print":{"date-parts":[[1988,9]]}},"alternative-id":["10.1002\/art.1780310906"],"URL":"https:\/\/doi.org\/10.1002\/art.1780310906","archive":["Portico"],"relation":{},"ISSN":["0004-3591","1529-0131"],"issn-type":[{"value":"0004-3591","type":"print"},{"value":"1529-0131","type":"electronic"}],"subject":[],"published":{"date-parts":[[1988,9]]}}}