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. 2022 Nov 2;61(11):4509-4513.
doi: 10.1093/rheumatology/keac120.

The performance of different classification criteria for systemic lupus erythematosus in a real-world rheumatology department

Brandon C H Tan  1 , Isaac Tang  1 , Julie Bonin  1 , Rachel Koelmeyer  1 , Alberta Hoi  1   2
Affiliations

The performance of different classification criteria for systemic lupus erythematosus in a real-world rheumatology department

Brandon C H Tan et al. Rheumatology (Oxford). .

Abstract

Objective: New classification criteria have been proposed to improve classification of systemic lupus erythematosus (SLE). We aimed to evaluate their performance by determining their sensitivity, specificity and accuracy in a real-world rheumatology department.

Methods: SLE patients who were enrolled in the Australian Lupus Registry and Biobank were included and compared with controls recruited from other rheumatology clinics. Clinical and immunological features were reviewed, according to ACR 1997, SLICC 2012, EULAR/ACR 2019, or Systemic Lupus Erythematosus Risk Probability Index (SLERPI). Performance of each set of criteria was evaluated for the overall cohort and in a subgroup of patients with early SLE.

Results: The study included 394 SLE and 123 control patients with other rheumatological conditions. Sensitivity was highest using SLICC 2012 or SLERPI 2020 criteria. Specificity was highest using ACR 1997 criteria. The SLICC 2012 criteria had the highest overall accuracy at 94.4% (95% CI: 91.7, 97.1%). In the subgroup analysis of SLE patients with early disease, SLICC 2012 performed similarly well.

Conclusions: The sensitivity and specificity of each set of classification criteria vary slightly, with SLICC 2012 and SLERPI 2020 having the highest sensitivities and the ACR 1997 criteria having the highest specificity in our patient cohort. All classification criteria serve as good instructional aids for clinicians to understand SLE manifestations. For the Australian Lupus Registry and Biobank, we will continue to use the ACR 1997 and/or SLICC 2012 as entry to the observational cohort.

Keywords: Systemic lupus erythematosus; classification criteria; cohort studies; diagnosis.

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References

    1. Tsokos GC. Autoimmunity and organ damage in systemic lupus erythematosus. Nat Immunol 2020;21:605–14. - PMC - PubMed
    1. Cojocaru M, Cojocaru IM, Silosi I, Vrabie CD.. Manifestations of systemic lupus erythematosus. Maedica (Bucur) 2011;6:330–6. - PMC - PubMed
    1. Yu C, Gershwin ME, Chang C.. Diagnostic criteria for systemic lupus erythematosus: a critical review. J Autoimmun 2014;48–49:10–3. - PubMed
    1. Narain S, Richards HB, Satoh M. et al. Diagnostic accuracy for lupus and other systemic autoimmune diseases in the community setting. Arch Intern Med 2004;164:2435–41. - PubMed
    1. Lateef A, Petri M.. Unmet medical needs in systemic lupus erythematosus. Arthritis Res Ther 2012;14 (Suppl 4):S4. - PMC - PubMed

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