Evidence map›Paper›PMID 31385462›Full record

ArticleArthritis & rheumatology (Hoboken, N.J.)2019

2019 European League Against Rheumatism/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus.

Martin Aringer, Karen Costenbader, David Daikh, Ralph Brinks, Marta Mosca, Rosalind Ramsey-Goldman, Josef S Smolen, David Wofsy, Dimitrios T Boumpas, Diane L Kamen and 54 more

6 registry-linked trialsAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Arthritis & rheumatology (Hoboken, N.J.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 6 registered trials, which are not on this map. Cited by 1,249 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1,249citing papers in PubMed, 7 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05844917 naunknown statusnot on this mapstarted 2023, after this paper: background citation

Ultrasound-Based Detection Of Subclinical Arthritis Among Patients With Systemic Lupus

TypeinterventionalSponsorSohag UniversityRan2023 to 2023Enrolled50ConditionsUltrasoundArmsultrasound
NCT06210295 unknown statusnot on this mapstarted 2024, after this paper: background citation

What is Behind Anemia in Systemic Lupus Erythematosus With Special Reference to Referactory Anemia

TypeobservationalSponsorAssiut UniversityRan2024 to 2024Enrolled67ConditionsRefractory Anemia in Systemic Lupus ErythematosisArmsLaboratory investigtions
NCT06287125 not yet recruitingnot on this mapstarted 2024, after this paper: background citation

Renal Assessment for Early Detection of Renal Impairment in Systemic Sclerosis and Systemic Lupus Erythematosus Patients

TypeobservationalSponsorAssiut UniversityRan2024 to 2027Enrolled95ConditionsSystemic Sclerosis and Systemic Lupus ErythematousArmsRenal multi-parametric MRI, Renal doppler ultrasound, Serum CD147
NCT06586359 not yet recruitingnot on this mapstarted 2024, after this paper: background citation

Evaluation of Bone Mineral Density in Patients With Childhood-onset Systemic Lupus Erythematous, in Relation to Disease Clinical Criteria

TypeobservationalSponsorAssiut UniversityRan2024 to 2026Enrolled78ConditionsSystemic Lupus Erthematosus
NCT06936007 completednot on this mapstarted 2024, after this paper: background citation

Hematological Manifestations in Systemic Lupus Erythematosus: A Retrospective Cross-sectional Study From a Tertiary Care Center in Nepal

TypeobservationalSponsorPatan Academy of Health SciencesRan2024 to 2024Enrolled99ConditionsSystemic Lupus Erythematosus (SLE)
NCT07067606 not yet recruitingnot on this mapstarted 2025, after this paper: background citation

Role of Musculoskeletal Ultrasound for Early Detection of Synovitis in SLE Patient and Its Correlation With Disease Activity and Neutrophil-to-C3 Ratio.

TypeobservationalSponsorMervat Sayed Kamal SayedRan2025 to 2027Enrolled90ConditionsMusckloskeletal USArmsultrasound contrast
3 · Its place in the literature

Who cites it

1,249 citing papers in PubMed, 7 syntheses or guidelines pooled it.

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1,189 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

64 authors.

Martin AringerUniversity Medical Center and Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany.
Karen CostenbaderBrigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
David DaikhVA Medical Center and University of California, San Francisco.
Ralph BrinksHeinrich Heine University Dusseldorf, Dusseldorf, Germany.
Marta MoscaUniversity of Pisa, Pisa, Italy.
Rosalind Ramsey-GoldmanNorthwestern University Feinberg School of Medicine, Chicago, Illinois.
Josef S SmolenMedical University of Vienna, Vienna, Austria.
David WofsyUniversity of California, San Francisco.
Dimitrios T BoumpasNational and Kapodestrian University of Athens Medical School and Biomedical Research Foundation of the Academy of Athens, Athens, Greece, and University of Cyprus Medical School, Nicosia, Cyprus.
Diane L KamenMedical University of South Carolina, Charleston.
David JayneUniversity of Cambridge, Cambridge, UK.
Ricard CerveraHospital Clínic, University of Barcelona, Barcelona, Spain.
Nathalie Costedoat-ChalumeauCochin Hospital, Center de référence maladies auto-immunes et systémiques rares d'île de France, Paris, France.
Betty DiamondThe Feinstein Institute for Medical Research, Manhasset, New York.
Dafna D GladmanToronto Western Hospital, University of Toronto, Toronto, Ontario, Canada.
Bevra HahnUniversity of California, Los Angeles.
Falk HiepeCharité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.
Søren JacobsenCopenhagen Lupus and Vasculitis Clinic, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Dinesh KhannaUniversity of Michigan, Ann Arbor.
Kirsten LerstrømLupus Europe, Essex, UK.
Elena MassarottiBrigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Joseph McCuneUniversity of Michigan, Ann Arbor.
Guillermo Ruiz-IrastorzaHospital Universitario Cruces, UPV/EHU, Barakaldo, Spain.
Jorge Sanchez-GuerreroMount Sinai Hospital/University Health Network, University of Toronto, Toronto, Ontario, Canada, and Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Matthias SchneiderHeinrich-Heine-University, Duesseldorf, Germany.
Murray UrowitzToronto Western Hospital, University of Toronto, Lupus Clinic, Toronto, Ontario, Canada.
George BertsiasUniversity of Crete Medical School, Heraklion, Crete, Greece.
Bimba F HoyerCharité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany, and University of Schleswig-Holstein at Kiel, Kiel, Germany.
Nicolai LeuchtenUniversity Medical Center and Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany.
Chiara TaniAzienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy.
Sara K TedeschiBrigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Zahi ToumaToronto Western Hospital, University of Toronto, Toronto, Ontario, Canada.
Gabriela SchmajukVA Medical Center and University of California, San Francisco.
Branimir AnicUniversity of Zagreb School of Medicine and University Hospital Center Zagreb, Zagreb, Croatia.
Florence AssanUniversité Paris Sud, Hôpitaux Universitaires Paris-Sud, AP-HP, INSERM 1184, Le Kremlin-Bicêtre, France.
Tak Mao ChanUniversity of Hong Kong, Hong Kong, China.
Ann Elaine ClarkeCumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Mary K CrowHospital for Special Surgery, New York, New York.
László CzirjákUniversity of Pécs, Pécs, Hungary.
Andrea DoriaUniversity of Padova, Padova, Italy.
Winfried GraningerMedical University of Graz, Graz, Austria.
Bernadett Halda-KissUniversity of Pécs, Pécs, Hungary.
Sarfaraz HasniNational Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland.
Peter M IzmirlyNew York University School of Medicine, New York, New York.
Michelle JungCumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Gábor KumánovicsUniversity of Pécs, Pécs, Hungary.
Xavier MarietteAP-HP, Hôpitaux universitaires Paris-Sud - Hôpital Bicêtre, and Université Paris-Sud, INSERM UMR 1184, Université Paris-Saclay, Le Kremlin Bicêtre, France.
Ivan PadjenUniversity of Zagreb School of Medicine and University Hospital Center Zagreb, Zagreb, Croatia.
José M Pego-ReigosaUniversity Hospital of Vigo, IRIDIS Group, Instituto de Investigación Sanitaria Galicia Sur (IISGS), Vigo, Spain.
Juanita Romero-DiazInstituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Íñigo Rúa-Figueroa FernándezDoctor Negrín University Hospital, Las Palmas de Gran Canaria, Las Palmas, Spain.
Raphaèle SerorUniversité Paris Sud, Hôpitaux Universitaires Paris-Sud, AP-HP, INSERM 1184, Le Kremlin-Bicêtre, France.
Georg H StummvollMedical University of Vienna, Vienna, Austria.
Yoshiya TanakaUniversity of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
Maria G TektonidouNational and Kapodistrian University of Athens Medical School, Athens, Greece.
Carlos VasconcelosCentro Hospitalar do Porto, University of Porto, Porto, Portugal.
Edward M VitalUniversity of Leeds, NIHR Leeds Biomedical Research Center, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Daniel J WallaceCedars-Sinai Medical Center, Los Angeles, California.
Sule YavuzIstanbul Bilim University, Istanbul, Turkey.
Pier Luigi MeroniIRCCS Istituto Auxologico Italiano, Milan, Italy.
Marvin J FritzlerCumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Ray NadenMcMaster University, Hamilton, Ontario, Canada.
Thomas DörnerCharité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.
Sindhu R JohnsonToronto Western Hospital, University Health Network, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.

Funding

Department of Health CS-2013-13-032Department of Health RTF/01/097European League Against RheumatismIntramural NIH HHS Z99 AR999999Intramural Research ProgramMedical Research Council MR/M01665X/1MRF_ MRF-159-0003-ELP-VITALNIAMS NIH HHSNIH
6 · The paper itself

Abstract

objectiveTo develop new classification criteria for systemic lupus erythematosus (SLE) jointly supported by the European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR).

methodsThis international initiative had four phases. 1) Evaluation of antinuclear antibody (ANA) as an entry criterion through systematic review and meta-regression of the literature and criteria generation through an international Delphi exercise, an early patient cohort, and a patient survey. 2) Criteria reduction by Delphi and nominal group technique exercises. 3) Criteria definition and weighting based on criterion performance and on results of a multi-criteria decision analysis. 4) Refinement of weights and threshold scores in a new derivation cohort of 1,001 subjects and validation compared with previous criteria in a new validation cohort of 1,270 subjects.

resultsThe 2019 EULAR/ACR classification criteria for SLE include positive ANA at least once as obligatory entry criterion; followed by additive weighted criteria grouped in 7 clinical (constitutional, hematologic, neuropsychiatric, mucocutaneous, serosal, musculoskeletal, renal) and 3 immunologic (antiphospholipid antibodies, complement proteins, SLE-specific antibodies) domains, and weighted from 2 to 10. Patients accumulating ≥10 points are classified. In the validation cohort, the new criteria had a sensitivity of 96.1% and specificity of 93.4%, compared with 82.8% sensitivity and 93.4% specificity of the ACR 1997 and 96.7% sensitivity and 83.7% specificity of the Systemic Lupus International Collaborating Clinics 2012 criteria.

conclusionThese new classification criteria were developed using rigorous methodology with multidisciplinary and international input, and have excellent sensitivity and specificity. Use of ANA entry criterion, hierarchically clustered, and weighted criteria reflects current thinking about SLE and provides an improved foundation for SLE research.

Indexed as

AdultAntibodies, AntinuclearAntibodies, AntiphospholipidAutoantibodiesCohort StudiesComplement System ProteinsDecision Support TechniquesDelphi TechniqueEuropeFemaleHumansInternational CooperationLupus Erythematosus, SystemicMaleMiddle AgedRheumatologyAntibodies, AntinuclearAntibodies, AntiphospholipidAutoantibodiesComplement System Proteins

Identifiers

PMID31385462
PMCPMC6827566

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.