Kenji Oku1, Tatsuya Atsumi1, Yuji Akiyama2, Hirofumi Amano3, Naoto Azuma4, Toshiyuki Bohgaki1, Yu Funakubo Asanuma2, Tetsuya Horita1, Tadashi Hosoya5, Kunihiro Ichinose6, Masaru Kato1, Yasuhiro Katsumata7, Yasushi Kawaguchi7, Atsushi Kawakami6, Tomohiro Koga6, Hitoshi Kohsaka5, Yuya Kondo8, Kanae Kubo9, Masataka Kuwana10, Akio Mimori11, Tsuneyo Mimori12, Toshihide Mimura2, Kosaku Murakami12, Kazuhisa Nakano13, Shingo Nakayamada13, Hiroshi Ogishima8, Kazumasa Ohmura1, Kazuyoshi Saito13, Hajime Sano4, Mihoko Shibuya9, Yuko Takahashi11, Yoshinari Takasaki3, Tsutomu Takeuchi14, Naoto Tamura3, Yoshiya Tanaka13, Hiroto Tsuboi8, Shinichiro Tsunoda4, Naoichiro Yukawa12, Noriyuki Yamakawa12,15, Kazuhiko Yamamoto9, Takayuki Sumida8. 1. a Division of Rheumatology, Endocrinology and Nephrology , Hokkaido University Graduate School of Medicine , Sapporo , Japan. 2. b Department of Rheumatology and Applied Immunology , Saitama Medical University , Saitama , Japan. 3. c Department of Internal Medicine and Rheumatology, Faculty of Medicine , Juntendo University , Tokyo , Japan. 4. d Division of Rheumatology, Department of Internal Medicine , Hyogo College of Medicine , Nishinomiya , Japan. 5. e Department of Rheumatology, Graduate School of Medical and Dental Sciences , Tokyo Medical and Dental University (TMDU) , Tokyo , Japan. 6. f Department of Immunology and Rheumatology , Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan. 7. g Institute of Rheumatology , Tokyo Women's Medical University , Tokyo , Japan. 8. h Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine , University of Tsukuba , Tsukuba , Japan. 9. i Department of Allergy and Rheumatology, Faculty of Medical Sciences , The University of Tokyo , Tokyo , Japan. 10. j Department of Allergy and Rheumatology , Nippon Medical School , Tokyo , Japan. 11. k Division of Rheumatic Diseases , National Center for Global Health and Medicine , Tokyo , Japan. 12. l Department of Rheumatology and Clinical Immunology , Kyoto University , Kyoto , Japan. 13. m The First Department of Internal Medicine, School of Medicine , University of Occupational and Environmental Health , Kitakyushu , Japan. 14. n Department of Internal Medicine , Keio University School of Medicine , Tokyo , Japan. 15. o Department of Rheumatology , Kyoto-Katsura Hospital , Kyoto , Japan.
Abstract
OBJECTIVE: To evaluate the performance of the 2012 Systemic Lupus International Collaborating Clinics criteria (SLICC-12) on classifying systemic lupus erythematosus (SLE) in an uncontrolled multi-centered study with real-life scenario of the patients in Japan. METHODS: This study comprised 495 patients with SLE or non-SLE rheumatic diseases and allied conditions from 12 institutes in Japan. Chart review of each patient was performed by the 27 expert rheumatologists and diagnosis of 487 cases reached to the consensus. Value of the SLICC-12 on SLE classification was analyzed comparing with the 1997 revised American College of Rheumatology SLE classification criteria (ACR-97) employing the expert-consented diagnoses. RESULTS: Compared to the ACR-97, the SLICC-12 had a higher sensitivity (ACR-97 vs. SLICC-12: 0.88 vs. 0.99, p < .01) and comparable specificity (0.85 vs. 0.80). The rate of misclassification (0.14 vs. 0.11) or the area under the receiver operating characteristic curves (0.863 vs. 0.894) was not statistically different. In the cases that diagnoses corresponded in high rates among experts, both criteria showed high accordance of SLE classification over 85% with the expert diagnoses. CONCLUSION: Although employment of SLICC-12 for the classification for SLE should be carefully considered, the SLICC-12 showed the higher sensitivity on classifying SLE in Japanese population.
OBJECTIVE: To evaluate the performance of the 2012 Systemic Lupus International Collaborating Clinics criteria (SLICC-12) on classifying systemic lupus erythematosus (SLE) in an uncontrolled multi-centered study with real-life scenario of the patients in Japan. METHODS: This study comprised 495 patients with SLE or non-SLE rheumatic diseases and allied conditions from 12 institutes in Japan. Chart review of each patient was performed by the 27 expert rheumatologists and diagnosis of 487 cases reached to the consensus. Value of the SLICC-12 on SLE classification was analyzed comparing with the 1997 revised American College of Rheumatology SLE classification criteria (ACR-97) employing the expert-consented diagnoses. RESULTS: Compared to the ACR-97, the SLICC-12 had a higher sensitivity (ACR-97 vs. SLICC-12: 0.88 vs. 0.99, p < .01) and comparable specificity (0.85 vs. 0.80). The rate of misclassification (0.14 vs. 0.11) or the area under the receiver operating characteristic curves (0.863 vs. 0.894) was not statistically different. In the cases that diagnoses corresponded in high rates among experts, both criteria showed high accordance of SLE classification over 85% with the expert diagnoses. CONCLUSION: Although employment of SLICC-12 for the classification for SLE should be carefully considered, the SLICC-12 showed the higher sensitivity on classifying SLE in Japanese population.
Entities:
Keywords:
American College of Rheumatology (ACR); Systemic lupus erythematosus (SLE); classification criteria; systemic lupus erythematosus established by Systemic Lupus International Collaborating Clinics (SLICC)