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Application of the 2012 Systemic Lupus International Collaborating Clinics classification criteria to patients in a regional Swedish systemic lupus erythematosus register

Overview of attention for article published in Arthritis Research & Therapy, January 2015
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Title
Application of the 2012 Systemic Lupus International Collaborating Clinics classification criteria to patients in a regional Swedish systemic lupus erythematosus register
Published in
Arthritis Research & Therapy, January 2015
DOI 10.1186/s13075-015-0521-9
Pubmed ID
Authors

Anna Ighe, Örjan Dahlström, Thomas Skogh, Christopher Sjöwall

Abstract

IntroductionIn 2012, the Systemic Lupus International Collaborating Clinics (SLICC) network presented a new set of criteria (SLICC-12) to classify systemic lupus erythematosus (SLE). The present study is the first to evaluate the performance of SLICC-12 on an adult European study population. Thus, SLICC-12 was applied on confirmed SLE cases in our regional SLE register as well as on individuals with a fair suspicion of systemic autoimmune disease who were referred to rheumatology specialist at our unit.MethodsWe included 243 confirmed SLE cases meeting the 1982 American College of Rheumatology (ACR-82) classification criteria and/or the Fries ¿diagnostic principle¿ (presence of antinuclear antibodies (ANA) on at least one occasion plus involvement of at least two defined organ systems) and 55 controls with possible systemic autoimmune disease, including the presence of any SLE-related autoantibody.ResultsSLICC-12 showed a diagnostic sensitivity of 94% (95% confidence interval (CI) 0.90 to 0.96) compared with 90% (95% CI 0.85 to 0.93) for the updated set of ACR criteria from 1997 (ACR-97), whereas ACR-82 failed to identify every fifth true SLE case. However, the disease specificity of SLICC-12 reached only 74% (95% CI 0.60 to 0.84) and did not change much when requiring involvement of at least two different organs as an indicator of systemic disease. In addition, SLICC-12 misclassified more of the controls than ACR-82, ACR-97 and Fries.ConclusionsEstablishing a standard definition of SLE continues to challenge lupus researchers and clinicians. We confirm that SLICC-12 has advantages with regard to diagnostic sensitivity, whereas we found the diagnostic specificity to be surprisingly low. To accomplish increased sensitivity and specificity figures, a combination of criteria sets for clinical SLE studies should be considered.

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The data shown below were compiled from readership statistics for 73 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 1%
Germany 1 1%
Unknown 71 97%

Demographic breakdown

Readers by professional status Count As %
Student > Master 18 25%
Researcher 12 16%
Other 11 15%
Student > Postgraduate 6 8%
Student > Ph. D. Student 5 7%
Other 6 8%
Unknown 15 21%
Readers by discipline Count As %
Medicine and Dentistry 41 56%
Immunology and Microbiology 6 8%
Biochemistry, Genetics and Molecular Biology 5 7%
Agricultural and Biological Sciences 3 4%
Mathematics 1 1%
Other 4 5%
Unknown 13 18%