Lupus & antiphospholipid syndrome
Evaluating the Threshold Score for Classification of Systemic Lupus Erythematosus Using the EULAR/American College of Rheumatology (ACR) Criteria
Authors' conclusion
The EULAR/ACR SLE classification criteria threshold score of 10 performs well, particularly among those with early disease and across sexes and ethnicities.
Study context
- Population
- Systemic lupus erythematosus (SLE) cases and disease-based control patients; threshold scores evaluated in early disease (disease duration ≤ 5 years)
- Participants
- 2,764 cases
- Exposure
- EULAR/ACR SLE classification criteria (threshold scores 6 to 12) in SLE cases vs disease-based control subjects
- SLE casesn = 1,980
- Controln = 784reference
- Outcome
- Operating characteristics of the EULAR/ACR SLE criteria score: sensitivity, specificity, +LR and -LR
Methodological detailsdiagnostic accuracy
- Diagnostic accuracy
Main finding
As reported in the abstract
EULAR/ACR SLE criteria operating characteristics
| Group | Sensitivity | Specificity | +LR | -LR |
|---|---|---|---|---|
| EULAR/ACR SLE criteria | 98% (95% CI 97-98) | 99% (95% CI 98-100) | 95.5 (95% CI 48.0-190) | 0.03 (95% CI 0.02-0.03) |
EULAR/ACR SLE criteria
Sensitivity98% (95% CI 97-98)
Specificity99% (95% CI 98-100)
+LR95.5 (95% CI 48.0-190)
-LR0.03 (95% CI 0.02-0.03)
Observational data: associations, not effects.
Further findings
| Outcome | Threshold score 10 | Threshold score 11 |
|---|---|---|
| -LR when threshold score raised from 10 to 11 (significant worsening) | ||
| -LR (95% CI 0.02-0.03) | 0.03 | — not stated in the abstract |
| -LR (95% CI 0.04-0.06) | — not stated in the abstract | 0.05 |
— not stated in the abstract
Early disease (duration ≤5 years): score of 10 maximised accurate classification
- +LR at score of 10, early disease
- 174.4 (95% CI 43.8-694.6)
- -LR at score of 10, early disease
- 0.03 (95% CI 0.02-0.04)
Performance in subgroups (early disease, women, men, White, Black, Chinese, Filipino)
- The criteria operated well in those with early disease, in women, in men, and in White, Black, Chinese, and Filipino people
Original publication
Evaluating the Threshold Score for Classification of Systemic Lupus Erythematosus Using the EULAR/ACR Criteria. J Rheumatol. Published 1 November 2022. doi:10.
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