Evidence map›Paper›PMID 32816709›Full record

ArticleAnnals of the rheumatic diseases2020

Performance of the 2019 EULAR/ACR classification criteria for systemic lupus erythematosus in early disease, across sexes and ethnicities.

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

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Article in Annals of the rheumatic diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed, 2 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

34 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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  8. [Clincial Diagnostic Performance of EULAR/ACR-2019, SLICC-2012, and ACR-1997 Classification Criteria for Childhood Systemic Lupus Erythematosus].Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition · 2025
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

64 authors.

Sindhu R JohnsonDivision of Rheumatology, Department of Medicine, Toronto Western Hospital, Mount Sinai Hospital; Institute of Health Policy, Management and Evaulation, University of Toronto, Toronto, Ontario, Canada Sindhu.Johnson@uhn.ca martin.aringer@uniklinikum-dresden.de.ORCID 0000-0003-0591-2976
Ralph BrinksPoliclinic and Hiller Research Unit of Rheumatology, Heinrich-Heine-University Duesseldorf, Düsseldorf, Germany.
Karen H CostenbaderDepartment of Medicine, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
David DaikhMedicine/Rheumatology, UCSF Medical Center, San Francisco, California, USA.
Marta MoscaRheumatology Unit, University of Pisa, Pisa, Italy.
Rosalind Ramsey-GoldmanMedicine/Rheumatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Josef S SmolenRheumatology, Medical University of Vienna, Vienna, Austria.
David WofsyDivision of Rheumatology, , Russell/Engleman Rheumatology Research Center, University of California, San Francisco, San Francisco, California, USA.
Dimitrios T BoumpasMedicine, National and Kapodestrian University of Athens, and Biomedical Research Foundation of the Athens Academy, Athens, Greece.ORCID 0000-0002-9812-4671
Diane L KamenRheumatology, Medical University of South Carolina, Charleston, South Carolina, USA.
David JayneMedicine, University of Cambridge, Cambridge, UK.
R CerveraAutoimmune Diseases, Hospital Clinic, University of Barcelona, Barcelona, Catalonia, Spain.
Nathalie Costedoat-ChalumeauInternal Medicine, Hospital Cochin, Paris, Île-de-France, France.ORCID 0000-0002-1555-9021
Betty DiamondAutoimmune and Musculoskeletal, Feinstein Institutes for Medical Research, Manhasset, New York, USA.
Dafna D GladmanMedicine, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0002-9074-0592
Bevra HahnRheumatology, UCLA School of Medicine, Los Angeles, California, USA.
Falk HiepeRheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Søren JacobsenDepartment of Rheumatology, Copenhagen Lupus and Vasculitis Clinic, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Dinesh KhannaDivision of Rheumatology, University of Michigan, Ann Arbor, Michigan, USA.ORCID 0000-0003-1412-4453
Kirsten LerstrømLupus Europe, Romford, UK.
Elena MassarottiRheumatology, Harvard Medical School, Boston, Massachusetts, USA.
Joseph McCuneDivision of Rheumatology, University of Michigan, Ann Arbor, Michigan, USA.
Guillermo Ruiz-IrastorzaAutoimmune Diseases Unit, Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces, Barakaldo, País Vasco, Spain.ORCID 0000-0001-7788-1043
Jorge Sanchez-GuerreroMedicine, Mount Sinai Hospital/University Health Network, University of Toronto, Toronto, Ontario, Canada.
Matthias SchneiderPoliclinic and Hiller Research Unit for Rheumatology, Medical Faculty,Heinrich-Heine-University, Düsseldorf, Germany.
Murray UrowitzMedicine, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0001-7506-9166
George BertsiasRheumatology, University of Crete School of Medicine, Iraklio, Crete, Greece.
Bimba F HoyerRheumatology and Clinical Immunology, University of Schleswig-Holstein at Kiel, Kiel, Germany.
Nicolai LeuchtenMedicine III, University Medical Center and Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany.
Chiara TaniRheumatology, Azienda Ospedaliero Universitaria Pisana, Pisa, Toscana, Italy.
Sara K TedeschiRheumatology, Harvard Medical School, Boston, Massachusetts, USA.
Zahi ToumaDivision of Rheumatology, Department of Medicine, Toronto Western Hospital, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Gabriela SchmajukDepartment of Medicine, Division of Rheumatology, University of California, San Francisco, San Francisco, California, USA.
Branimir AnicDivision of Clinical Immunology and Rheumatology, Department of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia.
Florence AssanINSERM UMR 1163, Université Paris Sud, Hôpitaux Universitaires Paris-Sud, AP-HP, INSERM UMR 1184, Paris, France.ORCID 0000-0001-6988-6178
Tak Mao ChanDepartment of Medicine, University of Hong Kong, Pokfulam, Hong Kong.
Ann Elaine ClarkeRheumatology, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.
Mary K CrowMary Kirkland Center for Lupus Research, Hospital for Special Surgery, New York, New York, USA.
László CzirjákDepartment of Rheumatology and Immunology, University of Pécs, Pécs, Hungary.
Andrea DoriaDivision of Rheumatology, University of Padova, Padova, Italy.ORCID 0000-0003-0548-4983
Winfried B GraningerRheumatology and Immunology, Medical University Graz, Graz, Austria.
Bernadett Halda-KissDepartment of Rheumatology and Immunology, University of Pécs, Pécs, Hungary.
Sarfaraz HasniRheumatology, NIAMS, National Institutes of Health, Bethesda, Maryland, USA.
Peter M IzmirlyRheumatology, New York University School of Medicine, New York, New York, USA.
Michelle JungRheumatology, University of Calgary, Calgary, Alberta, Canada.
Gábor KumánovicsDepartment of Rheumatology and Immunology, University of Pécs, Pécs, Hungary.
Xavier MarietteHôpitaux Universitaires Paris-Sud, AP-HP, INSERM UMR, Université Paris Sud, Le Kremlin-Bicêtre, France.
Ivan PadjenDivision of Clinical Immunology and Rheumatology, University of Zagreb School of Medicine and University Hospital Centre Zagreb, Zagreb, Croatia.
José M Pego-ReigosaRheumatology, University Hospital of Vigo, IRIDIS Group, Instituto de Investigación Sanitaria Galicia Sur, Vigo, Spain.
Juanita Romero-DiazImmunology and Rheumatology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Tlalpan, Mexico.
Íñigo Rúa-FigueroaRheumatology, Dr Negrin University Hospital of Gran Canaria, Las Palmas de Gran Canaria, Spain.ORCID 0000-0002-7894-1690
Raphaèle SerorINSERM UMR 1163, Université Paris Sud, Hôpitaux Universitaires Paris-Sud, AP-HP, INSERM UMR 1184, Paris, France.
Georg H StummvollRheumatology, Medical University of Vienna, Vienna, Austria.
Yoshiya TanakaFirst Department of Internal Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.ORCID 0000-0002-0807-7139
Maria G TektonidouMedical School, National and Kapodistrian University of Athens, Athinon, Greece.ORCID 0000-0003-2238-0975
Carlos VasconcelosCentro Hospitalar do Porto, ICBAS, University of Porto, Porto, Portugal.
Edward M VitalLeeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.
D J WallaceRheumatology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Sule YavuzRheumatology, Istanbul Bilim Universitesi, Istanbul, Turkey.ORCID 0000-0001-5053-6426
Pier Luigi MeroniClinical Immunology and Rheumatology, IRCCS Istituto Auxologico Italiano, Milan, Italy.ORCID 0000-0002-3394-1451
Marvin J FritzlerMedicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.
Ray NadenMedicine, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada.
Thomas DörnerRheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.ORCID 0000-0002-6478-7725
Martin AringerRheumatology, University Medical Center and Faculty of Medicine Carl Gustav Carus, Dresden, Germany Sindhu.Johnson@uhn.ca martin.aringer@uniklinikum-dresden.de.ORCID 0000-0003-4471-8375

Funding

Department of Health CS-2013-13-032Department of Health RTF/01/097Medical Research Council MR/M01665X/1MRF_ MRF-159-0003-ELP-VITAL
6 · The paper itself

Abstract

objectivesThe European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) 2019 Classification Criteria for systemic lupus erythematosus (SLE) have been validated with high sensitivity and specificity. We evaluated the performance of the new criteria with regard to disease duration, sex and race/ethnicity, and compared its performance against the Systemic Lupus International Collaborating Clinics (SLICC) 2012 and ACR 1982/1997 criteria.

methodsTwenty-one SLE centres from 16 countries submitted SLE cases and mimicking controls to form the validation cohort. The sensitivity and specificity of the EULAR/ACR 2019, SLICC 2012 and ACR 1982/1997 criteria were evaluated.

resultsThe cohort consisted of female (n=1098), male (n=172), Asian (n=118), black (n=68), Hispanic (n=124) and white (n=941) patients; with an SLE duration of 1 to <3 years (n=196) and ≥5 years (n=879). Among patients with 1 to <3 years disease duration, the EULAR/ACR criteria had better sensitivity than the ACR criteria (97% vs 81%). The EULAR/ACR criteria performed well in men (sensitivity 93%, specificity 96%) and women (sensitivity 97%, specificity 94%). Among women, the EULAR/ACR criteria had better sensitivity than the ACR criteria (97% vs 83%) and better specificity than the SLICC criteria (94% vs 82%). Among white patients, the EULAR/ACR criteria had better sensitivity than the ACR criteria (95% vs 83%) and better specificity than the SLICC criteria (94% vs 83%). The EULAR/ACR criteria performed well among black patients (sensitivity of 98%, specificity 100%), and had better sensitivity than the ACR criteria among Hispanic patients (100% vs 86%) and Asian patients (97% vs 77%).

conclusionsThe EULAR/ACR 2019 criteria perform well among patients with early disease, men, women, white, black, Hispanic and Asian patients. These criteria have superior sensitivity than the ACR criteria and/or superior specificity than the SLICC criteria across many subgroups.

Indexed as

Severity of Illness IndexFemaleHumansLupus Erythematosus, SystemicMalePatient SelectionSensitivity and Specificityepidemiologylupus nephritisoutcomes researchsystemic lupus erythematosus

Identifiers

PMID32816709

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