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European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) SLE classification criteria item performance.
Aringer, Martin; Brinks, Ralph; Dörner, Thomas; Daikh, David; Mosca, Marta; Ramsey-Goldman, Rosalind; Smolen, Josef S; Wofsy, David; Boumpas, Dimitrios T; Kamen, Diane L; Jayne, David; Cervera, R; Costedoat-Chalumeau, Nathalie; Diamond, Betty; Gladman, Dafna D; Hahn, Bevra; Hiepe, Falk; Jacobsen, Søren; Khanna, Dinesh; Lerstrøm, Kirsten; Massarotti, Elena; McCune, Joseph; Ruiz-Irastorza, Guillermo; Sanchez-Guerrero, Jorge; Schneider, Matthias; Urowitz, Murray; Bertsias, George; Hoyer, Bimba F; Leuchten, Nicolai; Schmajuk, Gabriela; Tani, Chiara; Tedeschi, Sara K; Touma, Zahi; Anic, Branimir; Assan, Florence; Chan, Tak Mao; Clarke, Ann Elaine; Crow, Mary K; Czirják, László; Doria, Andrea; Graninger, Winfried; Halda-Kiss, Bernadett; Hasni, Sarfaraz; Izmirly, Peter M; Jung, Michelle; Kumánovics, Gábor; Mariette, Xavier; Padjen, Ivan; Pego-Reigosa, José M; Romero-Diaz, Juanita.
Afiliación
  • Aringer M; University Medical Center and Faculty of Medicine, Department of Medicine III, Division of Rheumatology, TU Dresden, Dresden, Germany martin.aringer@uniklinikum-dresden.de Sindhu.Johnson@uhn.ca.
  • Brinks R; Policlinic and Hiller Research Unit for Rheumatology, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany.
  • Dörner T; Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.
  • Daikh D; Oregon Health and Sciences University and Portland VA Health Care System, Portland, Oregon, USA.
  • Mosca M; Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy.
  • Ramsey-Goldman R; Medicine/ Rheumatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
  • Smolen JS; Medical University of Vienna, Wien, Austria.
  • Wofsy D; Russell/ Engleman Rheumatology Research Center, University of California, San Francisco, San Francisco, California, USA.
  • Boumpas DT; Medicine, National and Kapodestrian University of Athens, Athens, Greece.
  • Kamen DL; Medical University of South Carolina, Charleston, South Carolina, USA.
  • Jayne D; Division of Nephrology, Department of Medicine, University of Cambridge, Cambridge, UK.
  • Cervera R; Department of Autoimmune Diseases, Hospital Clínic, University of Barcelona, Barcelona, Spain.
  • Costedoat-Chalumeau N; Internal Medicine, Centre de référence maladies auto-immunes et systémiques rares d'île de France, Cochin Hospital, Université Paris Descartes-Sorbonne Paris Cité, Paris, France.
  • Diamond B; The Feinstein Institute for Medical Research, Manhasset, New York, USA.
  • Gladman DD; Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
  • Hahn B; Rheumatology, UCLA School of Medicine, Los Angeles, California, USA.
  • Hiepe F; Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.
  • Jacobsen S; Copenhagen Lupus and Vasculitis Clinic, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen, Denmark.
  • Khanna D; Division of Rheumatology, University of Michigan, Ann Arbor, Michigan, USA.
  • Lerstrøm K; LUPUS EUROPE, Romford, UK.
  • Massarotti E; Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
  • McCune J; Harvard Medical School, Boston, Massachusetts, USA.
  • Ruiz-Irastorza G; Division of Rheumatology, University of Michigan, Ann Arbor, Michigan, USA.
  • Sanchez-Guerrero J; Autoimmune Diseases Unit, Department of Internal Medicine, Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces, UPV/EHU, Bizkaia, The Basque Country, Spain.
  • Schneider M; Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y Nutricion, Mexico City, Mexico.
  • Urowitz M; Department of Medicine, Mount Sinai Hospital/University Health Network, University of Toronto, Toronto, Ontario, Canada.
  • Bertsias G; Policlinic and Hiller Research Unit for Rheumatology, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany.
  • Hoyer BF; Division of Rheumatology, Department of Medicine, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada.
  • Leuchten N; Rheumatology, Clinical Immunology and Allergy, University of Crete School of Medicine, Heraklion, Greece.
  • Schmajuk G; Laboratory of Autoimmunity-Inflammation, Institute of Molecular Biology and Biotechnology, Heraklion, Greece.
  • Tani C; Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.
  • Tedeschi SK; Department of Rheumatology and Clinical Immunology, University of Schleswig-Holstein at Kiel, Kiel, Germany.
  • Touma Z; University Medical Center and Faculty of Medicine, Department of Medicine III, Division of Rheumatology, TU Dresden, Dresden, Germany.
  • Anic B; Department of Medicine, Division of Rheumatology, University of California at San Francisco and the VA Medical Center, San Francisco, California, USA.
  • Assan F; Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy.
  • Chan TM; Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
  • Clarke AE; Harvard Medical School, Boston, Massachusetts, USA.
  • Crow MK; Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
  • Czirják L; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
  • Doria A; Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Zagreb School of Medicine and University Hospital Centre Zagreb, Zagreb, Croatia.
  • Graninger W; INSERM UMR 1163, Université Paris Sud, Hôpitaux Universitaires Paris-Sud, AP-HP, INSERM UMR 1184, Paris, France.
  • Halda-Kiss B; Department of Medicine, University of Hong Kong, Pokfulam, Hong Kong.
  • Hasni S; Division of Rheumatology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
  • Izmirly PM; Mary Kirkland Center for Lupus Research, Hospital for Special Surgery, New York, New York, USA.
  • Jung M; Department of Rheumatology and Immunology, University of Pécs, Pécs, Hungary.
  • Kumánovics G; Division of Rheumatology, University of Padova, Padova, Italy.
  • Mariette X; Internal Medicine, Medical University of Graz, Graz, Austria.
  • Padjen I; Department of Rheumatology and Immunology, University of Pécs, Pécs, Hungary.
  • Pego-Reigosa JM; Lupus Clinical Research Program, Office of the Clinical Director, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, USA.
  • Romero-Diaz J; Rheumatology, New York University School of Medicine, New York, New York, USA.
Ann Rheum Dis ; 80(6): 775-781, 2021 06.
Article en En | MEDLINE | ID: mdl-33568386
BACKGROUND/OBJECTIVES: The European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) 2019 classification criteria for systemic lupus erythematosus system showed high specificity, while attaining also high sensitivity. We hereby analysed the performance of the individual criteria items and their contribution to the overall performance of the criteria. METHODS: We combined the EULAR/ACR derivation and validation cohorts for a total of 1197 systemic lupus erythematosus (SLE) and n=1074 non-SLE patients with a variety of conditions mimicking SLE, such as other autoimmune diseases, and calculated the sensitivity and specificity for antinuclear antibodies (ANA) and the 23 specific criteria items. We also tested performance omitting the EULAR/ACR criteria attribution rule, which defines that items are only counted if not more likely explained by a cause other than SLE. RESULTS: Positive ANA, the new entry criterion, was 99.5% sensitive, but only 19.4% specific, against a non-SLE population that included other inflammatory rheumatic, infectious, malignant and metabolic diseases. The specific criteria items were highly variable in sensitivity (from 0.42% for delirium and 1.84% for psychosis to 75.6% for antibodies to double-stranded DNA), but their specificity was uniformly high, with low C3 or C4 (83.0%) and leucopenia <4.000/mm³ (83.8%) at the lowest end. Unexplained fever was 95.3% specific in this cohort. Applying the attribution rule improved specificity, particularly for joint involvement. CONCLUSIONS: Changing the position of the highly sensitive, non-specific ANA to an entry criterion and the attribution rule resulted in a specificity of >80% for all items, explaining the higher overall specificity of the criteria set.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Reumatología / Enfermedades Reumáticas / Lupus Eritematoso Sistémico Tipo de estudio: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: Ann Rheum Dis Año: 2021 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Reumatología / Enfermedades Reumáticas / Lupus Eritematoso Sistémico Tipo de estudio: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: Ann Rheum Dis Año: 2021 Tipo del documento: Article Pais de publicación: Reino Unido