Original scientific paper
https://doi.org/10.3325/cmj.2019.60.333
Validation of the new classification criteria for systemic lupus erythematosus on a patient cohort from a national referral center: a retrospective study
Marija Bakula
orcid.org/0000-0002-0176-362X
; Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, University Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
Nada Čikeš
; Center for Translational and Clinical Research, University ofZagreb School of Medicine andUniversity Hospital Center Zagreb, Zagreb, Croatia
Branimir Anić
; Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, University Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
Abstract
Aim To validate Systemic Lupus International Collaborating
Clinics (SLICC)-12 and American College of Rheumatology
(ACR)-97 classification criteria on a patient cohort from
the University Hospital Center Zagreb.
Methods This retrospective study, conducted from 2014
to 2016, involved 308 patients with systemic lupus erythematosus
(SLE) (n = 146) and SLE-allied conditions (n = 162).
Patients’ medical charts were evaluated by an expert rheumatologist
to confirm the clinical diagnosis, regardless of
the number of the ACR-97 criteria met. Overall sensitivity
and specificity, as well as the sensitivity and specificity according
to disease duration, were compared between ACR-
97 and SLICC-12 classifications. Predictive value for SLE for
both classifications was assessed using logistic regression
and receiver operating characteristic (ROC) curves. Results The SLICC-12 criteria had significantly higher sensitivity
in early disase, which increased with disease duration.
The ACR-97 criteria had higher specificity. The specificity
of the SLICC-12 criteria was low and decreased with
disease duration. Regression analysis demonstrated the
superiority of the SLICC-12 classification criteria over the
ACR-97 criteria, with areas under the ROC curve of 0.801
and 0.780, respectively.
Conclusion Although the SLICC-12 criteria were superior
to the ACR-97 and were more sensitive for diagnosing
early SLE, their specificity in our population was too low.
The sensitivity of the SLICC-12 classification is increased by
better defined clinical features within each criterion. Our
results contribute to the current initiative for developing
new criteria for SLE.
Keywords
Hrčak ID:
240099
URI
Publication date:
15.8.2019.
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