Title
Derivation and validation of the systemic lupus international collaborating clinics classification criteria for systemic lupus erythematosus
Date Issued
01 August 2012
Access level
open access
Resource Type
journal article
Author(s)
Petri M.
Orbai A.M.
Gordon C.
Merrill J.T.
Fortin P.R.
Bruce I.N.
Isenberg D.
Wallace D.J.
Nived O.
Sturfelt G.
Ramsey-Goldman R.
Bae S.C.
Hanly J.G.
Sánchez-Guerrero J.
Clarke A.
Aranow C.
Manzi S.
Urowitz M.
Gladman D.
Kalunian K.
Costner M.
Werth V.P.
Zoma A.
Bernatsky S.
Ruiz-Irastorza G.
Khamashta M.A.
Jacobsen S.
Buyon J.P.
Maddison P.
Dooley M.A.
Van Vollenhoven R.F.
Ginzler E.
Stoll T.
Peschken C.
Jorizzo J.L.
Callen J.P.
Lim S.S.
Fessler B.J.
Inanc M.
Kamen D.L.
Rahman A.
Steinsson K.
Franks A.G.
Sigler L.
Hameed S.
Fang H.
Pham N.
Brey R.
Weisman M.H.
McGwin G.
Magder L.S.
University of Alabama
Publisher(s)
John Wiley and Sons Inc
Abstract
Objective 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. Methods 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. Results 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). Conclusion 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. Copyright © 2012 by the American College of Rheumatology.
Start page
2677
End page
2686
Volume
64
Issue
8
Language
English
OCDE Knowledge area
Reumatología Políticas de salud, Servicios de salud
Scopus EID
2-s2.0-84864470206
PubMed ID
Source
Arthritis and Rheumatism
ISSN of the container
00043591
Sponsor(s)
National Institute of Arthritis and Musculoskeletal and Skin Diseases T32AR048522
Sources of information: Directorio de Producción Científica Scopus