TY - JOUR
TI - Use of consensus methodology to determine candidate items for systemic lupus erythematosus classification criteria
AU - Johnson, S.R.
AU - Khanna, D.
AU - Daikh, D.
AU - Cervera, R.
AU - Costedoat-Chalumeau, N.
AU - Gladman, D.D.
AU - Hahn, B.H.
AU - Hiepe, F.
AU - Sánchez-Guerrero, J.
AU - Massarotti, E.
AU - Boumpas, D.T.
AU - Costenbader, K.H.
AU - Jayne, D.
AU - Dörner, T.
AU - Kamen, D.L.
AU - Mosca, M.
AU - Ramsey-Goldman, R.
AU - Smolen, J.S.
AU - Wofsy, D.
AU - Aringer, M.
JO - Indian Journal of Rheumatology
PY - 2019
VL - 46
TODO - 7
SP - 721-726
PB - Journal of Rheumatology
SN - null
TODO - 10.3899/jrheum.180478
TODO - antinuclear antibody;  autoantibody;  complement component C3;  complement component C4;  antinuclear antibody;  complement component C3;  complement component C4, alopecia;  antibody titer;  arthritis;  Article;  Austria;  Canada;  central nervous system disease;  cohort analysis;  consensus;  controlled study;  cytopenia;  disease classification;  disease course;  female;  fever;  France;  Germany;  Greece;  human;  immunofluorescence;  inflammation;  Italy;  kidney biopsy;  lupus erythematosus nephritis;  male;  medical education;  Mexico;  oral mucosal disease;  priority journal;  Spain;  systemic lupus erythematosus;  United States;  biopsy;  blood;  classification;  Europe;  immunology;  kidney;  lupus erythematosus nephritis;  lymphocytopenia;  North America;  pathology;  psychology;  rheumatologist;  systemic lupus erythematosus;  thrombocytopenia, Antibodies, Antinuclear;  Biopsy;  Complement C3;  Complement C4;  Consensus;  Europe;  Humans;  Kidney;  Lupus Erythematosus, Systemic;  Lupus Nephritis;  Lymphopenia;  North America;  Rheumatologists;  Thrombocytopenia
TODO - Objective. Given the complexity and heterogeneity of systemic lupus erythematosus (SLE), high-performing classification criteria are critical to advancing research and clinical care. A collaborative effort by the European League Against Rheumatism and the American College of Rheumatology was undertaken to generate candidate criteria, and then to reduce them to a smaller set. The objective of the current study was to select a set of criteria that maximizes the likelihood of accurate classification of SLE, particularly early disease. Methods. An independent panel of international SLE experts and the SLE classification criteria steering committee (conducting SLE research in Canada, Mexico, United States, Austria, Germany, Greece, France, Italy, and Spain) ranked 43 candidate criteria. A consensus meeting using nominal group technique (NGT) was conducted to reduce the list of criteria for consideration. Results. The expert panel NGT exercise reduced the candidate criteria for SLE classification from 43 to 21. The panel distinguished potential "entry criteria," which would be required for classification, from potential "additive criteria." Potential entry criteria were antinuclear antibody (ANA) = 1:80 (HEp-2 immunofluorescence), and low C3 and/or low C4. The use of low complement as an entry criterion was considered potentially useful in cases with negative ANA. Potential additive criteria included lupus nephritis by renal biopsy, autoantibodies, cytopenias, acute and chronic cutaneous lupus, alopecia, arthritis, serositis, oral mucosal lesions, central nervous system manifestations, and fever. Conclusion. The NGT exercise resulted in 21 candidate SLE classification criteria. The next phases of SLE classification criteria development will require refinement of criteria definitions, evaluation of the ability to cluster criteria into domains, and evaluation of weighting of criteria. Copyright © 2019. All rights reserved.
ER -