Lupus & antiphospholipid syndrome
Real-world validation of the Systemic Lupus Erythematosus Risk Probability Index (SLERPI) diagnostic model with concordance and discordance analysis across established systemic lupus erythematosus (SLE) classification criteria
Authors' conclusion
SLE classification frameworks show substantial overlap in real-world practice, with discordance driven by phenotype-specific prioritization of disease domains rather than random failure.
Study context
- Population
- 655 expert-confirmed SLE patients and 626 controls with other rheumatic diseases655 SLE, 626 controls
- Participants
- 1,281 patients
- Comparison
- SLERPI vs ACR-1997, SLICC-2012 and EULAR/ACR-2019 classification criteria, against expert clinical diagnosis
- Outcome
- Diagnostic performance vs expert clinical diagnosis as reference standard
Methodological detailsmulticentre, cross-sectional
- Multicentre
- Cross-sectional
Performance
As reported in the abstract
Diagnostic performance
| Test or model | Sensitivity | AUC |
|---|---|---|
| SLERPI | 99.2% | 0.989 |
SLERPI
Sensitivity99.2%
AUC0.989
- All four systems: sensitivities ranging
- 95.1-99.2%
- All four systems: specificities ranging
- 87.7-90.4%
Further findings
| Outcome | SLERPI | NRI |
|---|---|---|
| Early disease (≤ 1 year) subgroup | ||
| Sensitivity | 98.0% | |
| AUC | 0.987 | |
| Net reclassification improvementSLERPI vs ACR-1997 | + 2.7% | |
| Net reclassification improvementSLERPI vs SLICC-2012 | + 1.6% | |
| Net reclassification improvementSLERPI vs EULAR/ACR-2019 | + 4.3% |
Concordance and discordance
- Patients classified by all four sets
- 91.6%
- Discordant cases
- 8.4%
- ACR-1997 frequently missed immunologically active or hematologic-dominant cases; EULAR/ACR-2019 underperformed in mucocutaneous-predominant disease
- Cluster analysis identified four coherent subgroups of missed classifications
- SLERPI showed the lowest discordance, residual misclassifications confined to hematologic-dominant phenotypes
Original publication
Real-world validation of the SLERPI diagnostic model with concordance and discordance analysis across established SLE classification criteria. Arthritis Res Ther. Published 10 February 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →