European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) SLE classification criteria item performance
- 10 February 2021
- journal article
- research article
- Published by BMJ in Annals Of The Rheumatic Diseases
- Vol. 80 (6), 775-781
- https://doi.org/10.1136/annrheumdis-2020-219373
Abstract
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 80% for all items, explaining the higher overall specificity of the criteria set.This publication has 23 references indexed in Scilit:
- Performance of Antinuclear Antibodies for Classifying Systemic Lupus Erythematosus: A Systematic Literature Review and Meta‐Regression of Diagnostic DataArthritis Care & Research, 2018
- Multicenter Delphi Exercise to Identify Important Key Items for Classifying Systemic Lupus ErythematosusArthritis Care & Research, 2017
- Developing and Refining New Candidate Criteria for Systemic Lupus Erythematosus Classification: An International CollaborationArthritis Care & Research, 2017
- Toward new criteria for systemic lupus erythematosus—a standpointLupus, 2016
- Rhupus syndrome: Assessment of its prevalence and its clinical and instrumental characteristics in a prospective cohort of 103 SLE patientsAutoimmunity Reviews, 2013
- Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosusArthritis & Rheumatism, 2012
- Classification criteria in rheumatic diseases: A review of methodologic propertiesArthritis Care & Research, 2007
- Presence of antibodies against cyclic citrullinated peptides in patients with 'rhupus': a cross-sectional studyArthritis Research & Therapy, 2006
- Updating the American college of rheumatology revised criteria for the classification of systemic lupus erythematosusArthritis & Rheumatism, 1997
- The 1982 revised criteria for the classification of systemic lupus erythematosusArthritis & Rheumatism, 1982