Validation of the 2017 Weighted criteria compared to the 1997 ACR and the 2012 SLICC in Pediatric Systemic Lupus Erythematosus.
Arthritis Care Res
OBJECTIVE:Different classification criteria for systemic lupus erythematosus (SLE) have been proposed over many years. The most widely used and accepted criteria has been the 1997 ACR criteria. In 2012, the SLICC criteria were published in an attempt to improve clinical relevance of SLE criteria. In 2017, weighted criteria were proposed that included entry criteria, something the 1997 and the 2012 criteria did not identify. Our aim was to validate the 2017 weighted, 1997 ACR, and 2012 SLICC criteria and compare the sensitivities and specificities in pediatric SLE. METHODS:Retrospective chart review over the past 15 years of patients diagnosed with SLE before 19 years. Autoimmune controls were patients referred for serologies positive for ANA but did not fulfill criteria for diagnosis of SLE at the initial visit, or were diagnosed with another autoimmune disease. The three classification criteria were applied to these patients and compared against a gold standard of physician diagnosis. RESULTS:156 patients were diagnosed with SLE. The sensitivity for the 2017 weighted criteria was 0.974 (95% CI: 0.936-0.993) and specificity was 0.984 (95% CI: 0.966-0.994). The sensitivity for the 1997 ACR criteria was 0.872 (95% CI: 0.809-0.920) and specificity was 1.00 (95% CI: 0.990-1.000). The sensitivity for the 2012 SLICC criteria was 0.974 (95% CI: 0.936-0.993) and specificity was 0.997 (95% CI: 0.985-1.000). CONCLUSION:The 2017 weighted and 2012 SLICC were more sensitive than the 1997 ACR criteria. There were no significant differences in sensitivity and specificity between the 2012 SLICC and the 2017 weighted criteria. This article is protected by copyright. All rights reserved.
Faculty; Northwell Researcher
School of Medicine; Northwell Health