Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus.
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Author
Petri, MichelleOrbai, Ana-Maria
Alarcón, Graciela S
Gordon, Caroline
Merrill, Joan T
Fortin, Paul R
Bruce, Ian N
Isenberg, David
Wallace, Daniel J
Nived, Ola
Sturfelt, Gunnar
Ramsey-Goldman, Rosalind
Bae, Sang-Cheol
Hanly, John G
Sánchez-Guerrero, Jorge
Clarke, Ann
Aranow, Cynthia
Manzi, Susan
Urowitz, Murray
Gladman, Dafna
Kalunian, Kenneth
Costner, Melissa
Werth, Victoria P
Zoma, Asad
Bernatsky, Sasha
Ruiz-Irastorza, Guillermo
Khamashta, Munther A
Jacobsen, Soren
Buyon, Jill P
Maddison, Peter
Dooley, Mary Anne
van Vollenhoven, Ronald F
Ginzler, Ellen
Stoll, Thomas
Peschken, Christine
Jorizzo, Joseph L
Callen, Jeffrey P
Lim, S Sam
Fessler, Barri J
Inanc, Murat
Kamen, Diane L
Rahman, Anisur
Steinsson, Kristjan
Franks, Andrew G
Sigler, Lisa
Hameed, Suhail
Fang, Hong
Pham, Ngoc
Brey, Robin
Weisman, Michael H
McGwin, Gerald
Magder, Laurence S
Journal title
Arthritis and rheumatismPublication Volume
64Publication Issue
8Publication Begin page
2677Publication End page
86
Metadata
Show full item recordAbstract
The Systemic Lupus International Collaborating Clinics (SLICC) group revised and validated the American College of Rheumatology (ACR) systemic lupus erythematosus (SLE) classification criteria in order to improve clinical relevance, meet stringent methodology requirements, and incorporate new knowledge regarding the immunology of SLE.The classification criteria were derived from a set of 702 expert-rated patient scenarios. Recursive partitioning was used to derive an initial rule that was simplified and refined based on SLICC physician consensus. The SLICC group validated the classification criteria in a new validation sample of 690 new expert-rated patient scenarios.
Seventeen criteria were identified. In the derivation set, the SLICC classification criteria resulted in fewer misclassifications compared with the current ACR classification criteria (49 versus 70; P = 0.0082) and had greater sensitivity (94% versus 86%; P < 0.0001) and equal specificity (92% versus 93%; P = 0.39). In the validation set, the SLICC classification criteria resulted in fewer misclassifications compared with the current ACR classification criteria (62 versus 74; P = 0.24) and had greater sensitivity (97% versus 83%; P < 0.0001) but lower specificity (84% versus 96%; P < 0.0001).
The new SLICC classification criteria performed well in a large set of patient scenarios rated by experts. According to the SLICC rule for the classification of SLE, the patient must satisfy at least 4 criteria, including at least one clinical criterion and one immunologic criterion OR the patient must have biopsy-proven lupus nephritis in the presence of antinuclear antibodies or anti-double-stranded DNA antibodies.
Citation
Petri M, Orbai AM, Alarcón GS, Gordon C, Merrill JT, Fortin PR, Bruce IN, Isenberg D, Wallace DJ, Nived O, Sturfelt G, Ramsey-Goldman R, Bae SC, Hanly JG, Sánchez-Guerrero J, Clarke A, Aranow C, Manzi S, Urowitz M, Gladman D, Kalunian K, Costner M, Werth VP, Zoma A, Bernatsky S, Ruiz-Irastorza G, Khamashta MA, Jacobsen S, Buyon JP, Maddison P, Dooley MA, van Vollenhoven RF, Ginzler E, Stoll T, Peschken C, Jorizzo JL, Callen JP, Lim SS, Fessler BJ, Inanc M, Kamen DL, Rahman A, Steinsson K, Franks AG Jr, Sigler L, Hameed S, Fang H, Pham N, Brey R, Weisman MH, McGwin G Jr, Magder LS. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum. 2012 Aug;64(8):2677-86. doi: 10.1002/art.34473. PMID: 22553077; PMCID: PMC3409311.DOI
10.1002/art.34473ae974a485f413a2113503eed53cd6c53
10.1002/art.34473
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- Creative Commons
Except where otherwise noted, this item's license is described as Copyright © 2012 by the American College of Rheumatology.
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