Toward new criteria for systemic lupus erythematosus-a standpoint
Open accessAbstract
While clearly different in their aims and means, classification and diagnosis both try to accurately label the disease patients are suffering from. For systemic lupus erythematosus (SLE), this is complicated by the multi-organ nature of the disease and by our incomplete understanding of its pathophysiology. Hallmarks of SLE are the presence of antinuclear antibodies (ANA), and multiple immune-mediated organ symptoms that are largely independent. In an attempt to overcome limitations of the current sets of SLE classification criteria, a new four-phase approach is being developed, which is jointly supported by the European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR). This review attempts to delineate the performance of the current sets of criteria, the reasons for the decision for classification, and not diagnostic, criteria, and to provide a background of the current approach taken.
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?
Little information is given on the basis for inclusion of the anti-dsDNA test in the criteria, suggesting that this item is largely based on expert opinion.
“Little information is given on the basis for inclusion of the anti-dsDNA test in the criteria, suggesting that this item is largely based on expert opinion [24,25].”
From Anti-dsDNA antibodies in the classification criteria of systemic lupus erythematosus (2022) · cites this paper as [24]
In “SLE classification—the ACR and the SLICC criteria” (pp. 2–3), the paper says that the decisions to allow biopsy-proven lupus nephritis with ANA or anti-dsDNA to suffice for classification, and to require an immunological criterion, were more expert-driven than data-driven. It does not say that inclusion of the anti-dsDNA test itself was largely based on expert opinion; the Introduction (p. 2) also gives sensitivity and specificity estimates for that test. (LLM, conf=0.83)
Experimental — accuracy not yet measuredPositive anti-dsDNA antibodies received the highest Delphi score (8.94) which determined the highest score (6 points) in the weighted scoring of the disease.
“In fact, positive anti-dsDNA antibodies received the highest Delphi score (8.94) which determined the highest score (6 points) in the weighted scoring of the disease.”
From Anti-dsDNA antibodies in the classification criteria of systemic lupus erythematosus (2022) · cites this paper as [24]
The section “A process towards new classification criteria” (p. 5) reports a Delphi exercise that rated candidate SLE criteria, and “SLE diagnosis” (p. 4) discusses anti-dsDNA antibodies as relevant to SLE. But the paper does not give anti-dsDNA a Delphi score of 8.94 or a weight of six points; on p. 5, it says weighting will occur in a later phase. (LLM, conf=0.82)
Experimental — accuracy not yet measured
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
Aletaha, D., Neogi, T., Silman, A. J., Funovits, J., Felson, D. T., Bingham, C. O., Birnbaum, N. S., Burmester, G. R., Bykerk, V. P., Cohen, M. D., et al. (2010) · Arthritis & Rheumatism · doi:10.1002/art.27584 · Cited by 9,631 · see citing works
Aletaha, D., Neogi, T., Silman, A. J., Funovits, J., Felson, D. T., Bingham, C. O., Birnbaum, N. S., Burmester, G. R., Bykerk, V. P., Cohen, M. D., et al. (2010) · Annals of the Rheumatic Diseases · doi:10.1136/ard.2010.138461 · Cited by 4,959 · see citing works
Tsokos, G. C. (2016) · Elsevier eBooks · doi:10.1016/b978-0-323-37754-6.50094-4 · Cited by 3,990 · see citing works
van 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-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) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2013-204424 · Cited by 2,881 · see citing works
Self-citationTsokos, G. C. (2011) · New England Journal of Medicine · doi:10.1056/nejmra1100359 · Cited by 2,747 · see citing works
Development of Autoantibodies before the Clinical Onset of Systemic Lupus Erythematosus
Arbuckle, M. R., McClain, M. T., Rubertone, M. V., Scofield, R. H., Dennis, G. J., James, J. A., & Harley, J. B. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa021933 · Cited by 2,581 · see citing works
Rahman, A., & Isenberg, D. A. (2008) · New England Journal of Medicine · doi:10.1056/nejmra071297 · Cited by 1,633 · see citing works
Rahman, M. U. (2008) · Elsevier eBooks · doi:10.1016/b978-1-4160-4007-1.50153-x · Cited by 1,022 · see citing works
Agmon-Levin, N., Damoiseaux, J., Kallenberg, C., Sack, U., Witte, T., Herold, M., Bossuyt, X., Musset, L., Cervera, R., Plaza-Lopez, A., et al. (2014) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2013-203863 · Cited by 615 · see citing works
Immunologic Factors and Clinical Activity in Systemic Lupus Erythematosus
Schur, P. H., & Sandson, J. I. (1968) · New England Journal of Medicine · doi:10.1056/nejm196803072781004 · Cited by 590 · see citing works
Distinctions between diagnostic and classification criteria?
Aggarwal, R., Ringold, S., Khanna, D., Neogi, T., Johnson, S. R., Miller, A., Brunner, H. I., Ogawa, R., Felson, D., Ogdie, A., et al. (2015) · Arthritis Care & Research · doi:10.1002/acr.22583 · Cited by 539 · see citing works
Self-citationCervera, 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
Autoantibodies predate the onset of systemic lupus erythematosus in northern Sweden
Eriksson, C., Kokkonen, H., Johansson, M., et al. (2011) · Arthritis Research & Therapy · doi:10.1186/ar3258 · Cited by 232 · see citing works
Mähler, M., Meroni, P. L., Bossuyt, X., & Fritzler, M. J. (2014) · Journal of Immunology Research · doi:10.1155/2014/315179 · Cited by 206 · see citing works
Obermoser, G., Sontheimer, R. D., & Zelger, B. W. H. (2010) · Lupus · doi:10.1177/0961203310370048 · Cited by 190 · see citing works
Development 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
Inês, L., da Silva, J. A. P., Galindo-Izquierdo, M., López-Longo, F. J., Terroso, G., Romão, V. C., Rúa‐Figueroa, Í., Santos, M. J., Pego‐Reigosa, J. M., Nero, P., et al. (2015) · Arthritis Care & Research · doi:10.1002/acr.22539 · Cited by 155 · 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-citationDermatology position paper on the revision of the 1982 ACR criteria for systemic lupus erythematosus
Albrecht, J., Berlin, J. A., Braverman, I. M., Callen, J. P., Costner, M. I., Dutz, J. P., Fivenson, D. P., Franks, A. G., Jorizzo, J. L., Lee, L. A., et al. (2004) · Lupus · doi:10.1191/0961203304lu2020oa · Cited by 115 · see citing works
Ighe, A., Dahlström, Ö., Skogh, T., & Sjöwall, C. (2015) · Arthritis Research & Therapy · doi:10.1186/s13075-015-0521-9 · Cited by 105 · see citing works
Sağ, E., Tartaglione, A., Batu, E. D., et al. (2014) · PubMed · Cited by 97 · see citing works
Diagnostic Accuracy for Lupus and Other Systemic Autoimmune Diseases in the Community Setting
Narain, S., Richards, H. B., Satoh, M., et al. (2004) · Archives of Internal Medicine · doi:10.1001/archinte.164.22.2435 · Cited by 92 · see citing works
Lupus erythematosus tumidus is a separate subtype of cutaneous lupus erythematosus
Schmitt, V., Meuth, A., Amler, S., et al. (2009) · British Journal of Dermatology · doi:10.1111/j.1365-2133.2009.09401.x · Cited by 91 · see citing works
Autoantibody profiling to follow evolution of lupus syndromes
Olsen, N. J., Li, Q., Quan, J., et al. (2012) · Arthritis Research & Therapy · doi:10.1186/ar3927 · Cited by 81 · see citing works
Methodological 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
Grootscholten, C., van Bruggen, M. C. J., van der Pijl, J. W., et al. (2003) · Arthritis & Rheumatism · doi:10.1002/art.10974 · Cited by 74 · see citing works
Pons‐Estel, G., WOJDYLA, D. M., McGwin, G., Magder, L. S., Petri, M., Pons‐Estel, B. A., (GLADEL), O. B. O. T. G. L. D. E. D. L. E., Alarcón, G., & cohort, O. B. O. T. L. (2013) · Lupus · doi:10.1177/0961203313512883 · Cited by 70 · see citing works
Classification 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
Comparison between three systems of classification criteria in juvenile systemic lupus erythematous
Fonseca, A. R., Elsas, M., Land, M. G. P., & de Oliveira, S. K. F. (2014) · Rheumatology · doi:10.1093/rheumatology/keu278 · Cited by 68 · see citing works
Amezcua-Guerra, L. M., Higuera‐Ortiz, V., García, U. G. A., Gallegos‐Nava, S., & Hübbe‐Tena, C. (2014) · Arthritis Care & Research · doi:10.1002/acr.22422 · Cited by 64 · see citing works
Johnson, 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-citationTowards a better understanding of the clinical association of anti-DFS70 autoantibodies
Mähler, M., Meroni, P. L., Andrade, L. E. C., et al. (2015) · Autoimmunity Reviews · doi:10.1016/j.autrev.2015.11.006 · Cited by 62 · see citing works
ANA negative systemic lupus erythematosus sera revisited serologically
Reichlin, M. (2000) · Lupus · doi:10.1191/096120300678828091 · Cited by 53 · see citing works
Costenbader, K. H., & Schur, P. H. (2014) · Arthritis Care & Research · doi:10.1002/acr.22484 · Cited by 37 · see citing works
Messias-Reason, I., Hayashi, S. Y., Nisihara, R., et al. (2002) · Clinical & Experimental Immunology · doi:10.1046/j.1365-2249.2002.01772.x · Cited by 33 · see citing works
Marks, J. L., Holroyd, C. R., Dimitrov, B. D., et al. (2015) · Arthritis Care & Research · doi:10.1002/acr.22552 · Cited by 31 · see citing works
Lupus erythematosus tumidus: a clinical and histological study of 25 cases
Rodríguez-Caruncho, C., Bielsa, I., Fernández‐Figueras, M. T., et al. (2014) · Lupus · doi:10.1177/0961203314560204 · Cited by 28 · see citing works
Lots of autoantibodies equal lupus?
Aringer, M., & Vital, E. M. J. (2013) · Arthritis Research & Therapy · doi:10.1186/ar4126 · Cited by 13 · see citing works
Self-citationLeuchten, N., Brinks, R., Hoyer, A., et al. (2015) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2015-eular.4039 · Cited by 4 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 1
- 35 Leuchten N, Brinks R, Hoyer A, et al . Anti-nuclear antibodies have high sensitivity for systemic lupus erythematosus: Results of a systematic literature review and meta-regression of diagnostic data. Arthritis Rheumatol 2015; 67: #774 (abstract).
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-citationLeuchten, 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-citationTedeschi, S. K., Johnson, S. R., Boumpas, D., Daikh, D., Dörner, T., Jayne, D., Kamen, D., Lerstrøm, K., Mosca, M., Ramsey‐Goldman, R., et al. (2018) · Arthritis Care & Research · doi:10.1002/acr.23317 · Cited by 112 · see citing works
Self-citationAringer, 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-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-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
“Little information is given on the basis for inclusion of the antidsDNA test in the criteria, suggesting that this item is largely based on expert opinion [24,25].”
BackgroundOrme, 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
- Authors
- Aringer, M., Dörner, T., Leuchten, N., & Johnson, S. R.
- Affiliations
- University Hospital Carl Gustav Carus (DE)
- German Rheumatism Research Centre (DE)
- Mount Sinai Hospital (CA)
- Corresponding author
- Aringer, M
- Venue
- Lupus
- Publisher
- SAGE Publications
- Published
- 2016-05-31
- Volume
- 25
- Issue
- 8
- Pages
- 805-811
- ISSN
- 0961-2033 (ISSN-L)
- 1477-0962
- OpenAlex
- W2413629314
- Cited by
- 93
- References
- 43
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 9 · 2023: 6 · 2022: 11 · 2021: 15 · 2020: 14 · 2019: 18 · 2018: 6 · 2017: 7 · 2016: 2
- FWCI
- 1.75
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Lupus (publishedVersion)
- PubMed (publishedVersion)
- Qucosa (Saxon State and University Library Dresden) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Health Sciences › Medicine › Pathology and Forensic Medicine › Systemic Sclerosis and Related Diseases
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Vasculitis and related conditions
- Keywords
- systemic lupus erythematosus, classification criteria, diagnostic criteria, antinuclear antibodies, multi-organ involvement, ACR/EULAR classification criteria, disease classification
- MeSH terms
- Antibodies, Antinuclear, Humans, Lupus Erythematosus, Systemic, Mass Screening, Rheumatology, Societies, Medical
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
