Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus.
Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus.
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DOI：
10.1002/art.34473
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发表时间：
2012-08
影响因子：
--
通讯作者：
Magder, Laurence S.
中科院分区：
文献类型：
--
作者：
Petri, Michelle;Orbai, Ana-Maria;Alarcon, 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.;Sanchez-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., Jr.;Sigler, Lisa;Hameed, Suhail;Fang, Hong;Ngoc Pham;Brey, Robin;Weisman, Michael H.;McGwin, Gerald, Jr.;Magder, Laurence S.
系统性狼疮协作诊所（SLICC）修订并验证了美国风湿病学会（ACR）SLE分类标准，以提高临床相关性，满足严格的方法学要求，并纳入SLE免疫学的新知识。分类标准来自一组702个专家评定的患者场景。使用递归划分来导出基于SLICC医生共识简化和细化的初始规则。SLICC在690例SLE患者和对照组的新验证样本中验证了分类标准。确定了17项标准。SLE分类的SLICC标准要求：1）满足至少4项标准，至少1项临床标准和1项免疫学标准，或2）在ANA或抗dsDNA抗体存在的情况下，狼疮性肾炎作为唯一的临床标准。在推导集中，SLICC分类标准导致的错误分类比当前ACR分类标准更少（49对70，p=0.0082），具有更高的灵敏度（94%对86%，p<0.0001）和相等的特异性（92%对93%，p=0.39）。在验证集中，SLICC分类标准导致更少的错误分类（62对74，p=0.24），具有更高的灵敏度（97%对83%，p<0.0001），但特异性较低（84%对96%，p<0.0001）。新的SLICC分类标准在专家评定的大量患者场景中表现良好。他们要求至少有一个临床标准和一个免疫学标准存在的分类系统性红斑狼疮。活检证实肾炎与狼疮相容（在SLE自身抗体存在的情况下）足以进行分类。
The Systemic Lupus Collaborating Clinics (SLICC) revised and validated the American College of Rheumatology (ACR) SLE classification criteria in order to improve clinical relevance, meet stringent methodology requirements and incorporate new knowledge in SLE immunology. 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. SLICC validated the classification criteria in a new validation sample of 690 SLE patients and controls. Seventeen criteria were identified. The SLICC criteria for SLE classification requires: 1) Fulfillment of at least four criteria, with at least one clinical criterion AND one immunologic criterion OR 2) Lupus nephritis as the sole clinical criterion in the presence of ANA or anti-dsDNA antibodies. In the derivation set, the SLICC classification criteria resulted in fewer misclassifications than the current ACR classification criteria (49 versus 70, p=0.0082), 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 (62 versus 74, p=0.24), had greater sensitivity (97% versus 83%, p<0.0001) but less specificity (84% versus 96%, p<0.0001). The new SLICC classification criteria performed well on a large set of patient scenarios rated by experts. They require that at least one clinical criterion and one immunologic criterion be present for a classification of SLE. Biopsy confirmed nephritis compatible with lupus (in the presence of SLE autoantibodies) is sufficient for classification.
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影响因子：
19.6
作者：
Fine, Derek M.;Ziegenbein, Martina;Rovin, Brad H.
通讯作者：
Rovin, Brad H.
影响因子：
2.6
作者：
Hanly, JG
通讯作者：
Hanly, JG
影响因子：
--
作者：
CLOUGH, JD;ELRAZAK, M;WILLIAMS, GW
通讯作者：
WILLIAMS, GW
影响因子：
2.6
作者：
Isenberg, D
通讯作者：
Isenberg, D
影响因子：
2.6
作者：
Nived, O;Sturfelt, G
通讯作者：
Sturfelt, G