Multicriteria decision analysis process to develop new classification criteria for systemic lupus erythematosus

Sara K. Tedeschi; Sindhu R. Johnson; Dimitrios T. Boumpas; David Daikh; Thomas Dörner; Betty Diamond; Søren Jacobsen; David Jayne; Diane L. Kamen; W. Joseph McCune; Marta Mosca; Rosalind Ramsey-Goldman; Guillermo Ruiz-Irastorza; Matthias Schneider; Murray Urowitz; David Wofsy; Josef S. Smolen; Raymond P. Naden; Martin Aringer; Karen H. Costenbader

doi:10.1136/annrheumdis-2018-214685

Multicriteria decision analysis process to develop new classification criteria for systemic lupus erythematosus

Sara K. Tedeschi^*, Sindhu R. Johnson, Dimitrios T. Boumpas, David Daikh, Thomas Dörner, Betty Diamond, Søren Jacobsen, David Jayne, Diane L. Kamen, W. Joseph McCune, Marta Mosca, Rosalind Ramsey-Goldman, Guillermo Ruiz-Irastorza, Matthias Schneider, Murray Urowitz, David Wofsy, Josef S. Smolen, Raymond P. Naden, Martin Aringer, Karen H. Costenbader

^*Corresponding author for this work

Medicine, Rheumatology Division

Research output: Contribution to journal › Article › peer-review

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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)
Pages (from-to)	634-640
Number of pages	7
Journal	Annals of the rheumatic diseases
Volume	78
Issue number	5
DOIs	https://doi.org/10.1136/annrheumdis-2018-214685
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

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Cite this

Tedeschi, S. K., Johnson, S. R., Boumpas, D. T., Daikh, D., Dörner, T., Diamond, B., Jacobsen, S., Jayne, D., Kamen, D. L., McCune, W. J., Mosca, M., Ramsey-Goldman, R., Ruiz-Irastorza, G., Schneider, M., Urowitz, M., Wofsy, D., Smolen, J. S., Naden, R. P., Aringer, M., & Costenbader, K. H. (2019). Multicriteria decision analysis process to develop new classification criteria for systemic lupus erythematosus. Annals of the rheumatic diseases, 78(5), 634-640. https://doi.org/10.1136/annrheumdis-2018-214685

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title = "Multicriteria decision analysis process to develop new classification criteria for systemic lupus erythematosus",

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.",

keywords = "Clinical research, Methodology, Systemic lupus erythematosus",

author = "Tedeschi, {Sara K.} and Johnson, {Sindhu R.} and Boumpas, {Dimitrios T.} and David Daikh and Thomas D{\"o}rner and Betty Diamond and S{\o}ren Jacobsen and David Jayne and Kamen, {Diane L.} and McCune, {W. Joseph} and Marta Mosca and Rosalind Ramsey-Goldman and Guillermo Ruiz-Irastorza and Matthias Schneider and Murray Urowitz and David Wofsy and Smolen, {Josef S.} and Naden, {Raymond P.} and Martin Aringer and Costenbader, {Karen H.}",

note = "Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.",

year = "2019",

month = may,

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doi = "10.1136/annrheumdis-2018-214685",

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Tedeschi, SK, Johnson, SR, Boumpas, DT, Daikh, D, Dörner, T, Diamond, B, Jacobsen, S, Jayne, D, Kamen, DL, McCune, WJ, Mosca, M, Ramsey-Goldman, R, Ruiz-Irastorza, G, Schneider, M, Urowitz, M, Wofsy, D, Smolen, JS, Naden, RP, Aringer, M & Costenbader, KH 2019, 'Multicriteria decision analysis process to develop new classification criteria for systemic lupus erythematosus', Annals of the rheumatic diseases, vol. 78, no. 5, pp. 634-640. https://doi.org/10.1136/annrheumdis-2018-214685

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AU - Tedeschi, Sara K.

AU - Johnson, Sindhu R.

AU - Boumpas, Dimitrios T.

AU - Daikh, David

AU - Dörner, Thomas

AU - Diamond, Betty

AU - Jacobsen, Søren

AU - Jayne, David

AU - Kamen, Diane L.

AU - McCune, W. Joseph

AU - Mosca, Marta

AU - Ramsey-Goldman, Rosalind

AU - Ruiz-Irastorza, Guillermo

AU - Schneider, Matthias

AU - Urowitz, Murray

AU - Wofsy, David

AU - Smolen, Josef S.

AU - Naden, Raymond P.

AU - Aringer, Martin

AU - Costenbader, Karen H.

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AB - 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.

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Multicriteria decision analysis process to develop new classification criteria for systemic lupus erythematosus

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