Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus.

作者信息

Petri Michelle, Orbai 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

机构信息

Johns Hopkins University School of Medicine, 1830 East Monument Street, Suite 7500, Baltimore, MD 21205, USA.

出版信息

Arthritis Rheum. 2012 Aug;64(8):2677-86. doi: 10.1002/art.34473.

DOI:10.1002/art.34473

PMID:22553077

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3409311/

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.

摘要