Lupus & antiphospholipid syndrome
Validation of the 2019 EULAR/ACR classification criteria for systemic lupus erythematosus in an academic tertiary care centre
Authors' conclusion
In this cohort from an independent academic medical centre, the sensitivity and specificity of the 2019 lupus classification criteria were confirmed.
Study context
- Population
- Outpatients at an academic tertiary care centre: 606 with systemic lupus erythematosus (SLE), 1015 with non-SLE autoimmune-mediated rheumatic diseases (ARD) and 1756 with non-ARD diseases606 with SLE
- Participants
- 3,377 outpatients
- Comparison
- 2019 EULAR/ACR vs 1997 ACR classification criteria for SLE
- Outcome
- Sensitivity and specificity of the classification criteria for SLE
Methodological detailsprospective and retrospective observational cohort, single academic tertiary care centre
- Prospective and retrospective observational cohort
- Single academic tertiary care centre
Performance
As reported in the abstract
Sensitivity and specificity for SLE
| Test or model | Sensitivity | Specificity (entire cohort) | Specificity (non-SLE ARD) | Youden Index (SLE/non-SLE ARD) |
|---|---|---|---|---|
| 2019 EULAR/ACR | 87.0% | 98.1% | 96.5% | 0.835 |
| 1997 ACR | 81.8% | 99.5% | 98.8% | 0.806 |
Sensitivity
2019 EULAR/ACR87.0%
1997 ACR81.8%
Specificity (entire cohort)
2019 EULAR/ACR98.1%
1997 ACR99.5%
Specificity (non-SLE ARD)
2019 EULAR/ACR96.5%
1997 ACR98.8%
Youden Index (SLE/non-SLE ARD)
2019 EULAR/ACR0.835
1997 ACR0.806
Further findings
Individual criteria items
- Most sensitive items: history of antinuclear antibody (ANA) positivity and anti-dsDNA antibodies; these were also the least specific
- Most specific items: class III/IV LN and combination of low C3 and low C4, followed by class II/V LN, either low C3 or low C4, delirium and psychosis when not attributable to non-SLE causes
Agreement of 1997 and 2019 criteria
- Overall agreement very good
Original publication
Validation of the 2019 EULAR/ACR classification criteria for systemic lupus erythematosus in an academic tertiary care centre. RMD Open. Published 6 July 2023. doi:10.
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