Lupus & antiphospholipid syndrome
The 2023 American College of Rheumatology (ACR) / EULAR Antiphospholipid Syndrome Classification Criteria
Authors' conclusion
These new ACR/EULAR APS classification criteria were developed using rigorous methodology with multidisciplinary international input. Hierarchically clustered, weighted, and risk-stratified criteria reflect the current thinking about APS, providing high specificity and a strong foundation for future APS research.
Study context
- Population
- Validation cohort for antiphospholipid syndrome (APS) classification; gold standard independent adjudicators' consensus
- Comparison
- 2023 ACR/EULAR APS classification criteria vs 2006 revised Sapporo classification criteria
- Outcome
- Specificity and sensitivity for APS classification vs adjudicators' consensus
Methodological detailsinternational, multidisciplinary, 4 phases, modified Delphi and nominal group technique, consensus-based multicriteria decision analysis, validation vs independent adjudicators' consensus as gold standard, Phase I: criteria generation by surveys and literature review; Phase II: reduction by modified Delphi and nominal group technique; Phase III: definition, reduction with real-world patient scenarios, weighting and threshold identification; Phase IV: validation
- International
- Multidisciplinary
- 4 phases
- Modified Delphi and nominal group technique
- Consensus-based multicriteria decision analysis
- Validation vs independent adjudicators' consensus as gold standard
- Phase I: criteria generation by surveys and literature review; Phase II: reduction by modified Delphi and nominal group technique; Phase III: definition, reduction with real-world patient scenarios, weighting and threshold identification; Phase IV: validation
Performance
As reported in the abstract
Classification performance in the validation cohort
| Test or model | Sensitivity | Specificity |
|---|---|---|
| 2023 ACR/EULAR criteria | 84% | 99% |
| 2006 revised Sapporo criteria | 99% | 86% |
Sensitivity
2023 ACR/EULAR criteria84%
2006 revised Sapporo criteria99%
Specificity
2023 ACR/EULAR criteria99%
2006 revised Sapporo criteria86%
Original publication
The 2023 ACR / EULAR Antiphospholipid Syndrome Classification Criteria. Arthritis Rheumatol. Published 28 August 2023. doi:10.
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