ACR RE-CLASSIFICATION OF SLE CRITERIA (AROSE) ORIG GRANT REVISION OF ACR CLASSIF

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。目前的美国流变学学会（ACR）系统性红斑狼疮（SLE）的分类标准已被证明是不够的，在目前的研究气候。目前的标准过度代表皮肤狼疮，有4个标准（而其他器官只接受1个）。目前的标准需要更新，以代表血清学检测的进展（例如，补体成分，新的自身抗体），改进的诊断和实验室测试（例如，肾活组织检查结果，尿蛋白与肌酸酐的比率）和器官受累的更广泛定义（例如，将神经系统受累重新定义为不仅仅是“癫痫发作”或“精神病”）。系统性狼疮国际合作诊所（SLICC）为开发和验证SLE临床试验指标制定了合作和生产力标准，包括SLE疾病活动指数（SLDEAI）、SLICC损伤指数（后来也被ACR采用）和SF-36。SLlCC由全球近30个学术中心组成。在本研究中，SLlCC将：1）通过频率分析，识别所提出的分类标准的可行性; 2）将SLE患者和具有相关疾病的患者顺序地登记到系统方案中，以使用传统方法和分类树方法来测试所提出的分类标准;以及3）在新的患者集合中参与所生成的分类标准的验证练习。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The current American College of Rheumatology (ACR) classification criteria for systemic lupus erythematosus (SLE) have proven to be inadequate in the current research climate. The current criteria over-represent cutaneous lupus, with 4 criteria (whereas every other organ receives only 1). The current criteria need to be updated to represent advances in serologic testing (e.g., complement components, new autoantibodies), improved diagnostic and laboratory testing (e.g., renal biopsy findings, urine protein to creatinine ratios) and broader definitions of organ involvement (e.g., redefining neurologic involvement as more than "seizures" or "psychosis"). The Systemic Lupus International Collaborating Clinics (SLICC) has set a standard for cooperation and productivity in the development and validation of clinical trial measures for SLE, including the SLE Disease Activity lndex (SLDEAI), the SLlCC Damage lndex (later also adopted by the ACR), and the SF-36. SLlCC consists of nearly 30 academic centers world-wide. In this study, SLlCC will: 1)identify, by frequency analysis, the feasibility of proposed classification criteria; 2) sequentially enroll SLE patients and those with related diseases into a systematic protocol to test proposed classification criteria using traditional and classification tree methodology; and 3) participate in a validation exercise of the generated classification criteria in a new set of patients.