Abstract
European League Against Rheumatism and are jointly supporting multiphase development of systemic lupus erythematosus (SLE) classification criteria based on weighted criteria and a continuous probability scale. Prior steps included item generation, item reduction and hierarchical organisation of candidate criteria using an evidence-based approach. Our objectives were to determine relative weights using multicriteria decision analysis (MCDA) and to set a provisional threshold score for SLE classification. An SLE Expert Panel (8 European, 9 North American) submitted 164 real, unique cases with a wide range of SLE probability in a standardised format. Using the candidate criteria, experts scored and rank-ordered 20 representative cases. At an in-person meeting, experts reviewed inter-rater reliability of scoring, further refined criteria definitions and participated in an MCDA exercise. Based on expert consensus decisions on pairwise comparisons of criteria, 1000minds software calculated criteria weights and rank-ordered the remaining 144 cases based on their additive scores. The score of the lowest-ranked case for which complete expert consensus was achieved defined the provisional threshold classification score. Inter-rater reliability of scoring cases with the candidate criteria was good. MCDA involved 74 pairwise decisions and was repeated for the arthritis and mucocutaneous domains when the initial ranking of some cases did not match expert opinion. After criteria weights and additive scores were recalculated once, experts reached consensus for SLE classification for all cases scoring>83. Using an iterative process, the candidate criteria definitions were refined, preliminary weights were calculated and a provisional threshold score for SLE classification was determined.
Original language | English (US) |
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Pages (from-to) | 634-640 |
Number of pages | 7 |
Journal | Annals of the rheumatic diseases |
Volume | 78 |
Issue number | 5 |
DOIs | |
State | Published - May 1 2019 |
Funding
Funding This work was jointly supported by the European league against Rheumatism and the american college of Rheumatology. sKT\u2019s work on this project was supported in part by the lupus Foundation of america career development award and niams l30 aR070514. sRJ was supported by a canadian institutes of Health Research new investigator award. sJ was supported by a grant from the danish Rheumatism association (a-3865). A multinational effort to develop new classification criteria for systemic lupus erythematosus (SLE) for clinical research, jointly supported by the European League Against Rheumatism (EULAR) and American College of Rheumatology (ACR), is underway. The overarching goal is to develop a system that identifies potential participants for clinical research studies, requiring a degree of homogeneity among subjects while simultaneously dealing with the extreme heterogeneity of SLE.1 The aim was to design a system with the maximum combination of sensitivity and specificity for SLE, retaining face validity. While the classification criteria are not intended for diagnosis or clinical care, it is acknowledged that the only available \u2018gold standard\u2019 for the presence of SLE is expert clinician opinion. this project was supported in part by the Lupus Foundation of America Career Development Award and NIAMS L30 AR070514
Keywords
- Clinical research
- Methodology
- Systemic lupus erythematosus
ASJC Scopus subject areas
- Rheumatology
- Immunology and Allergy
- Immunology
- General Biochemistry, Genetics and Molecular Biology