Systemic sclerosis presents a great deal of variability among different patients in the extent of skin and internal organ involvement, the pace of the disease and consequently, the prognosis. In addition, the single patient, during his/her disease course, can present with distinct manifestations. Each patient must, therefore, be carefully investigated. The assessment should be adapted to the setting, i.e. clinical practice, clinical investigation, therapeutic trials. The clinician cannot confine the diagnostic process to labelling the disease. He must define the subset, the extent of internal organ involvement, and the type of lesions underlying the clinical manifestations, i.e. fibrotic lesions, reflecting irreversible damage should be separated from active lesions (such as alveolitis) which can be reversed by drug treatment. The clinical investigator must assure that his/her patients are comparable to other series. ACR criteria have been shown to not assure such comparability. To this purpose, a core set of variables to be assessed in any clinical investigation study has been proposed. Finally, the clinical researcher should enrol patients with active disease and must rely for his/her conclusions on feasible and sensitive to change measures. An OMERACT committee has recently reviewed the literature selecting those ready for use in clinical trials.

中文翻译：

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对系统性硬化症患者的评估。

系统性硬化症在皮肤和内部器官受累程度，疾病进展以及因此的预后方面，在不同患者之间呈现出很大的变异性。另外，单个病人在他/她的病程中可以表现出不同的表现。因此，必须仔细检查每个患者。评估应适应环境，即临床实践，临床研究，治疗试验。临床医生不能将诊断过程局限于标记疾病。他必须定义子集，内脏器官受累的程度以及临床表现的基础病变类型，即反映不可逆损害的纤维化病变，应与活动性病变（如肺泡炎）分开，可以通过药物治疗予以逆转。临床研究人员必须确保他/她的患者与其他系列患者相当。已经显示出ACR标准不能保证这种可比性。为此，已经提出了在任何临床研究中要评估的一组核心变量。最后，临床研究人员应招募患有活动性疾病的患者，并且必须以其结论基于可行且对变更措施敏感的结论。OMERACT委员会最近对文献进行了审查，选择了可用于临床试验的文献。临床研究人员应招募患有活动性疾病的患者，并且必须以其结论依赖可行且对变更措施敏感的结论。OMERACT委员会最近对文献进行了审查，选择了可用于临床试验的文献。临床研究人员应招募患有活动性疾病的患者，并且必须以其结论依赖可行且对变化措施敏感的结论。OMERACT委员会最近对文献进行了审查，选择了可用于临床试验的文献。