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Derivation and validation of the systemic lupus international collaborating clinics classification criteria for systemic lupus erythematosus

Petri, Michelle; Orbai, Ana-Maria; Alarcon, Graciela S.; Gordon, Caroline; Merrill, Joan T.; Fortin, Paul R.; Bruce, Ian N.; Isenberg, David; Wallace, Daniel J. and Nived, Ola LU , et al. (2012) In Arthritis and Rheumatism 64(8). p.2677-2686
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... (More)
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 antidouble-stranded DNA antibodies. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Arthritis and Rheumatism
volume
64
issue
8
pages
2677 - 2686
publisher
John Wiley & Sons
external identifiers
  • wos:000306906500028
  • scopus:84864470206
ISSN
1529-0131
DOI
10.1002/art.34473
language
English
LU publication?
yes
id
943c55a9-e4bb-41b9-ac7d-1d9e374f9dca (old id 3070170)
date added to LUP
2012-10-05 07:12:14
date last changed
2017-11-19 03:24:44
@article{943c55a9-e4bb-41b9-ac7d-1d9e374f9dca,
  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 &lt; 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 &lt; 0.0001) but lower specificity (84% versus 96%; P &lt; 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 antidouble-stranded DNA antibodies.},
  author       = {Petri, Michelle and Orbai, Ana-Maria and Alarcon, Graciela S. and Gordon, Caroline and Merrill, Joan T. and Fortin, Paul R. and Bruce, Ian N. and Isenberg, David and Wallace, Daniel J. and Nived, Ola and Sturfelt, Gunnar and Ramsey-Goldman, Rosalind and Bae, Sang-Cheol and Hanly, John G. and Sanchez-Guerrero, Jorge and Clarke, Ann and Aranow, Cynthia and Manzi, Susan and Urowitz, Murray and Gladman, Dafna and Kalunian, Kenneth and Costner, Melissa and Werth, Victoria P. and Zoma, Asad and Bernatsky, Sasha and Ruiz-Irastorza, Guillermo and Khamashta, Munther A. and Jacobsen, Soren and Buyon, Jill P. and Maddison, Peter and Dooley, Mary Anne and van vollenhoven, Ronald F. and Ginzler, Ellen and Stoll, Thomas and Peschken, Christine and Jorizzo, Joseph L. and Callen, Jeffrey P. and Lim, S. Sam and Fessler, Barri J. and Inanc, Murat and Kamen, Diane L. and Rahman, Anisur and Steinsson, Kristjan and Franks, Andrew G. and Sigler, Lisa and Hameed, Suhail and Fang, Hong and Pham, Ngoc and Brey, Robin and Weisman, Michael H. and McGwin, Gerald and Magder, Laurence S.},
  issn         = {1529-0131},
  language     = {eng},
  number       = {8},
  pages        = {2677--2686},
  publisher    = {John Wiley & Sons},
  series       = {Arthritis and Rheumatism},
  title        = {Derivation and validation of the systemic lupus international collaborating clinics classification criteria for systemic lupus erythematosus},
  url          = {http://dx.doi.org/10.1002/art.34473},
  volume       = {64},
  year         = {2012},
}