Developing and refining new candidate criteria for systemic lupus erythematosus classification: an international collaboration
Open accessAbstract
Objective: To define candidate criteria within multiphase development of systemic lupus erythematosus (SLE) classification criteria, jointly supported by the American College of Rheumatology and the European League Against Rheumatism. Prior steps included item generation and reduction by Delphi exercise, further narrowed to 21 items in a nominal group technique exercise. Our objectives were to apply an evidence‐based approach to the 21 candidate criteria, and to develop hierarchical organization of criteria within domains. Methods: A literature review identified the sensitivity and specificity of the 21 candidate criteria. Data on the performance of antinuclear antibody (ANA) as an entry criterion and operating characteristics of the candidate criteria in early SLE patients were evaluated. Candidate criteria were hierarchically organized into clinical and immunologic domains, and definitions were refined in an iterative process. Results: Based on the data, consensus was reached to use a positive ANA of ≥1:80 titer (HE p‐2 cells immunofluorescence) as an entry criterion and to have 7 clinical and 3 immunologic domains, with hierarchical organization of criteria within domains. Definitions of the candidate criteria were specified. Conclusion: Using a data‐driven process, consensus was reached on new, refined criteria definitions and organization based on operating characteristics. This work will be followed by a multicriteria decision analysis exercise to weight criteria and to identify a threshold score for classification on a continuous probability scale.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Definitions for many potential criteria are provided but not for anti-dsDNA antibodies.
“Definitions for many potential criteria are provided but not for anti-dsDNA antibodies [26].”
From Anti-dsDNA antibodies in the classification criteria of systemic lupus erythematosus (2022) · cites this paper as [26]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The 1982 revised criteria for the classification of systemic lupus erythematosus
Tan, E. M., Cohen, A. S., Fries, J. F., Masi, A. T., Mcshane, D. J., Rothfield, N. F., Schaller, J. G., Talal, N., & Winchester, R. J. (1982) · Arthritis & Rheumatism · doi:10.1002/art.1780251101 · Cited by 14,519 · see citing works
Hochberg, M. C. (1997) · Arthritis & Rheumatism · doi:10.1002/art.1780400928 · Cited by 11,409 · see citing works
MIYAKIS, S., LOCKSHIN, M. D., ATSUMI, T., BRANCH, D. W., BREY, R. L., CERVERA, R., DERKSEN, R. H. W. M., DE GROOT, P. G., KOIKE, T., MERONI, P. L., et al. (2006) · Journal of Thrombosis and Haemostasis · doi:10.1111/j.1538-7836.2006.01753.x · Cited by 7,203 · see citing works
Petri, M., Orbai, A., Alarcón, G. S., Gordon, C., Merrill, J. T., Fortin, P. R., Bruce, I. N., Isenberg, D., Wallace, D. J., Nived, O., et al. (2012) · Arthritis & Rheumatism · doi:10.1002/art.34473 · Cited by 5,322 · see citing works
Self-citationvan den Hoogen, F. H. J., Khanna, D., Fransen, J., Johnson, S. R., Baron, M. G., Tyndall, A., Matucci‐Cerinic, M., Naden, R. P., Medsger, T. A., Carreira, P. E., et al. (2013) · Arthritis & Rheumatism · doi:10.1002/art.38098 · Cited by 3,399 · see citing works
Self-citation2015 ESC Guidelines for the diagnosis and management of pericardial diseases
Adler, Y., Charron, P., Imazio, M., Badano, L. P., Barón‐Esquivias, G., Bogaert, J. G., Brucato, A. L., Guéret, P., Klingel, K., Lionis, C. D., et al. (2015) · European Heart Journal · doi:10.1093/eurheartj/ehv318 · Cited by 2,635 · see citing works
Firestein, G. S., & Manning, A. M. (1999) · Arthritis & Rheumatism · doi:10.1002/1529-0131(199904)42:4 · Cited by 2,191 · see citing works
The classification of glomerulonephritis in systemic lupus erythematosus revisited
Weening, J. J., ON Behalf of the International Society of Nephrology and Renal Pathology Society Working Group on the Classification Oflupus Nephritis, D’Agati, V. D., Schwartz, M. M., Seshan, S. V., Alpers, C. E., Appel, G. B., Balow, J. E., Bruijn, J. A., Cook, T. H., et al. (2004) · Kidney International · doi:10.1111/j.1523-1755.2004.00443.x · Cited by 1,649 · see citing works
Renal-Limited “Lupus-Like” Nephritis: How Much of a Lupus
AbuMaziad, A. S., Torrealba, J. R., Seikaly, M. G., Hassler, J. R., & Hendricks, A. R. (2017) · Case Reports in Nephrology and Dialysis · doi:10.1159/000475493 · Cited by 1,299 · see citing works
Neogi, T., Jansen, T., Dalbeth, N., Fransen, J., Schumacher, H. R., Berendsen, D., Brown, M., Choi, H. K., Edwards, N. L., Janssen, M., et al. (2015) · Arthritis & Rheumatology · doi:10.1002/art.39254 · Cited by 678 · see citing works
Self-citationDistinctive cutaneous subsets in the spectrum of lupus erythematosus
Gilliam, J. N., & Sontheimer, R. D. (1981) · Journal of the American Academy of Dermatology · doi:10.1016/s0190-9622(81)80261-7 · Cited by 536 · see citing works
Cervera, R., Khamashta, M. A., Font, J., Sebastiani, G. D., Gil, A., Lavilla, P., Aydintug, A., Jędryka-Góral, A., de Ramón, E., Fernández‐Nebro, A., et al. (1999) · Medicine · doi:10.1097/00005792-199905000-00003 · Cited by 429 · see citing works
Neogi, T., Aletaha, D., Silman, A. J., Naden, R. L., Felson, D. T., Aggarwal, R., Bingham, C. O., Birnbaum, N. S., Burmester, G. R., Bykerk, V. P., et al. (2010) · Arthritis & Rheumatism · doi:10.1002/art.27580 · Cited by 336 · see citing works
Self-citationDall'Era, M., Cisternas, M. G., Smilek, D. E., Straub, L., Houssiau, F. A., Cervera, R., Rovin, B. H., & Mackay, M. (2015) · Arthritis & Rheumatology · doi:10.1002/art.39026 · Cited by 329 · see citing works
Hanly, J. G., Urowitz, M. B., Sanchez‐Guerrero, J., et al. (2006) · Arthritis & Rheumatism · doi:10.1002/art.22305 · Cited by 321 · see citing works
Hanly, J. G., Urowitz, M. B., Su, L., Bae, S., Gordon, C., Wallace, D. J., Clarke, A. E., Bernatsky, S., Isenberg, D. A., Rahman, A., et al. (2009) · Annals of the Rheumatic Diseases · doi:10.1136/ard.2008.106351 · Cited by 312 · see citing works
Self-citationLiang, M. H., Schur, P. H., Fortin, P. R., Clair, E. W. S., Balow, J. E., Costenbader, K. H., Crofford, L. J., de Pablo, P., Dooley, M. A., Finckh, A., et al. (2006) · Arthritis & Rheumatism · doi:10.1002/art.21625 · Cited by 263 · see citing works
Self-citationNeuropsychiatric events in systemic lupus erythematosus: attribution and clinical significance.
Hanly, J. G., McCurdy, G., Fougere, L., Douglas, J.-A., & Thompson, K. J. (2004) · PubMed · Cited by 236 · see citing works
Leuchten, N., Hoyer, A., Brinks, R., Schoels, M., Schneider, M., Smolen, J., Johnson, S. R., Daikh, D., Dörner, T., Aringer, M., et al. (2018) · Arthritis Care & Research · doi:10.1002/acr.23292 · Cited by 190 · see citing works
Self-citationDevelopment of classification and response criteria for rheumatic diseases
Singh, J. A., Solomon, D. H., Dougados, M., Felson, D. T., HAWKER, G. A., Katz, P., Paulus, H., & Wallace, C. (2006) · Arthritis Care & Research · doi:10.1002/art.22003 · Cited by 185 · see citing works
Fever of unknown origin. An old friend revisited
Petersdorf, R. G. (1992) · Archives of Internal Medicine · doi:10.1001/archinte.152.1.21 · Cited by 174 · see citing works
Lu, R., Munroe, M. E., Guthridge, J. M., Bean, K. M., Fife, D. A., Chen, H., Slight-Webb, S. R., Keith, M. P., Harley, J. B., & James, J. A. (2016) · Journal of Autoimmunity · doi:10.1016/j.jaut.2016.06.001 · Cited by 162 · see citing works
Classification criteria in rheumatic diseases: A review of methodologic properties
Johnson, S. R., Goek, O. N., Singh‐Grewal, D., Vlad, S. C., Feldman, B. M., Felson, D. T., HAWKER, G. A., Singh, J. A., & Solomon, D. H. (2007) · Arthritis Care & Research · doi:10.1002/art.23018 · Cited by 137 · see citing works
Self-citationToward new criteria for systemic lupus erythematosus-a standpoint
Aringer, M., Dörner, T., Leuchten, N., & Johnson, S. R. (2016) · Lupus · doi:10.1177/0961203316644338 · Cited by 93 · see citing works
Self-citationValidation of potential classification criteria for systemic sclerosis
Johnson, S. R., Fransen, J., Khanna, D., Baron, M. G., van den Hoogen, F. H. J., Medsger, T. A., PESCHKEN, C. A., Carreira, P. E., Riemekasten, G., Tyndall, A., et al. (2011) · Arthritis Care & Research · doi:10.1002/acr.20684 · Cited by 86 · see citing works
Self-citationMethodological and statistical approaches to criteria development in rheumatic diseases
Felson, D. T., & Anderson, J. J. (1995) · Baillière s Clinical Rheumatology · doi:10.1016/s0950-3579(05)80189-x · Cited by 79 · see citing works
Putterman, C., Furie, R. A., Ramsey‐Goldman, R., Askanase, A., Buyon, J. P., KALUNIAN, K. C., Chatham, W. W., Massarotti, E. M., Kirou, K. A., Jordan, N., et al. (2014) · Lupus Science & Medicine · doi:10.1136/lupus-2014-000056 · Cited by 78 · see citing works
Self-citationClassification criteria for rheumatic diseases: Why and how?
Dougados, M., & Gossec, L. (2007) · Arthritis Care & Research · doi:10.1002/art.23015 · Cited by 68 · see citing works
Munroe, M. E., Young, K. A., Kamen, D. L., Guthridge, J. M., Niewold, T. B., Costenbader, K. H., Weisman, M. H., ISHIMORI, M. L., Wallace, D. J., Gilkeson, G. S., et al. (2016) · Arthritis & Rheumatology · doi:10.1002/art.40004 · Cited by 66 · see citing works
Self-citationSchmajuk, G., Hoyer, B. F., Aringer, M., Johnson, S. R., Daikh, D. I., Dörner, T., & the SLE classification criteria steering committee and the international SLE expert panel of the initiative (2018) · Arthritis Care & Research · doi:10.1002/acr.23503 · Cited by 65 · see citing works
Self-citationJohnson, S. R., Naden, R. P., Fransen, J., van den Hoogen, F. H. J., Pope, J. E., Baron, M. G., Tyndall, A., Matucci‐Cerinic, M., Denton, C. P., Distler, O., et al. (2014) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2013.12.009 · Cited by 63 · see citing works
Self-citationDevelopment of classification criteria for discoid lupus erythematosus: Results of a Delphi exercise
Elman, S. A., Joyce, C., Nyberg, F., Furukawa, F., Goodfield, M. J. D., Hasegawa, M., Marinović, B., Szepietowski, J. C., Dutz, J. P., Werth, V. P., et al. (2017) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2017.02.030 · Cited by 61 · see citing works
Aberle, T., Bourn, R. L., Munroe, M. E., Chen, H., Roberts, V., Guthridge, J. M., Bean, K. M., Robertson, J. M., Sivils, K. L. M., Rasmussen, A., et al. (2017) · Arthritis Care & Research · doi:10.1002/acr.23201 · Cited by 42 · see citing works
Li, H., Lin, S., Yang, S., Chen, L., & Zheng, X.-X. (2015) · Clinical Rheumatology · doi:10.1007/s10067-014-2843-4 · Cited by 29 · see citing works
Cluster Analysis of an Array of Autoantibodies in Neuropsychiatric Systemic Lupus Erythematosus
Zirkzee, E. J. M., Checa, C. M., Steup‐Beekman, G. M., et al. (2014) · The Journal of Rheumatology · doi:10.3899/jrheum.140027 · Cited by 8 · see citing works
Touma, Z., Costenbader, K. H., Johnson, S. R., et al. (2016) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2016-eular.4437 · Cited by 5 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 2
- [7]Hoyer BF Schmajuk G Aringer M Johnson SR Daikh DI Dorner T Multi-center Delphi exercise reveals important key items in classifying SLE [abstract] Arthritis Rheum 2015 67 Suppl 10 PMC6026087 29287313
- [15]Cohen AS Reynolds WE Franklin EC Kulka JP Ropes MW Shulman LE Preliminary criteria for the classification of systemic lupus erythematosus Bulletin Rheum Dis 1971 21 643 48
Cited by
Sorted by citations
Aringer, M., Costenbader, K., Daikh, D., Brinks, R., Mosca, M., Ramsey‐Goldman, R., Smolen, J. S., Wofsy, D., Boumpas, D. T., Kamen, D. L., et al. (2019) · Arthritis & Rheumatology · doi:10.1002/art.40930 · Cited by 2,677 · see citing works
Self-citationAringer, M., Costenbader, K., Daikh, D., Brinks, R., Mosca, M., Ramsey-Goldman, R., Smolen, J. S., Wofsy, D., Boumpas, D. T., Kamen, D. L., et al. (2019) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2018-214819 · Cited by 1,612 · see citing works
Self-citationDiagnosis and management of the antiphospholipid syndrome
Garcia, D., & Erkan, D. (2018) · New England Journal of Medicine · doi:10.1056/nejmra1705454 · Cited by 819 · see citing works
Aringer, M., Brinks, R., Dörner, T., Daikh, D., Mosca, M., Ramsey-Goldman, R., Smolen, J. S., Wofsy, D., Boumpas, D. T., Kamen, D. L., et al. (2021) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2020-219373 · Cited by 68 · see citing works
Self-citationAnti-dsDNA antibodies in the classification criteria of systemic lupus erythematosus
Infantino, M., Nagy, E., Bizzaro, N., Fischer, K., Bossuyt, X., & Damoiseaux, J. (2022) · Journal of Translational Autoimmunity · doi:10.1016/j.jtauto.2021.100139 · Cited by 38 · see citing works
Orme, M. E., Voreck, A., Aksouh, R., Ramsey-Goldman, R., & Schreurs, M. W. J. (2021) · Autoimmunity Reviews · doi:10.1016/j.autrev.2021.102943 · Cited by 34 · see citing works
Self-citation
- Authors
- Tedeschi, S. K., Johnson, S. R., Boumpas, D., Daikh, D., Dörner, T., Jayne, D., Kamen, D., Lerstrøm, K., Mosca, M., Ramsey‐Goldman, R., Sinnette, C., Wofsy, D., Smolen, J. S., Naden, R. P., Aringer, M., & Costenbader, K. H.
- Affiliations
- Brigham and Women's Hospital (US)
- University of Toronto (CA)
- University of Crete (GR)
- San Francisco VA Medical Center (US)
- Charité – Universitätsmedizin Berlin (DE)
- University of Cambridge (GB)
- Medical University of South Carolina (US)
- LUPUS EUROPE, Farum Denmark
- University of Pisa (IT)
- Northwestern University (US)
- University of California, San Francisco (US)
- Medical University of Vienna (AT)
- McMaster University (CA)
- University Hospital Carl Gustav Carus (DE)
- ORCID
- Venue
- Arthritis Care & Research
- Publisher
- Wiley
- Published
- 2018-02-22
- Volume
- 70
- Issue
- 4
- Pages
- 571-581
- ISSN
- 0893-7524 (ISSN-L)
- 2151-464X
- 2151-4658
- PMC
- PMC5996759
- OpenAlex
- W2735806626
- Cited by
- 112
- References
- 36
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 3 · 2023: 9 · 2022: 8 · 2021: 15 · 2020: 24 · 2019: 29 · 2018: 13 · 2017: 2
- FWCI
- 3.00
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Arthritis Care & Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Apollo (University of Cambridge) (submittedVersion)
- CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Apollo
- Funders
- European League Against Rheumatism
- Lupus Foundation of America
- National Institutes of Health
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (L30‐AR‐070514, K24‐AR‐066109)
- Canadian Institutes of Health Research
- Topics
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Health Sciences › Medicine › Pathology and Forensic Medicine › Systemic Sclerosis and Related Diseases
- Social Sciences › Sociology and Political Science › Delphi Technique in Research
- Keywords
- systemic lupus erythematosus, classification criteria, antinuclear antibodies, sensitivity and specificity, clinical domains, multi-criteria decision making, American College of Rheumatology, European League Against Rheumatism
- MeSH terms
- Antibodies, Antinuclear, Complement System Proteins, Delphi Technique, Europe, Humans, International Cooperation, Lupus Erythematosus, Systemic, Terminology as Topic, Predictive Value of Tests, Prognosis, Severity of Illness Index, United States, Reproducibility of Results, Biomarkers, Consensus
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
