ArticlePediatric rheumatology online journal2021
Evaluating the performance of ACR, SLICC and EULAR/ACR classification criteria in childhood onset systemic lupus erythematosus.
Article in Pediatric rheumatology online journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Evaluating performance of the 2019 EULAR/ACR, 2012 SLICC, and 1997 ACR criteria for classifying adult-onset and childhood-onset systemic lupus erythematosus: A systematic review and meta-analysis.Frontiers in medicine · 2022Pooled it
- Comparative diagnostic performance of ACR 1997, SLICC 2012, and EULAR/ACR 2019 criteria in childhood-onset systemic lupus erythematosus: A retrospective study from a tertiary care centre in south India.Rheumatology and immunology research · 2026Article
- Management of childhood-onset systemic lupus erythematosus (cSLE) over the last two decades in Spain.Pediatric rheumatology online journal · 2025Review
- Prediction of Lupus Classification Criteria via Generative AI Medical Record Profiling.Biotech (Basel (Switzerland)) · 2025Article
- Rare head and neck myositis with reversible myelodysplastic syndrome: The first reported lupus manifestation as an initial symptom.Qatar medical journal · 2025Article
- Validation and optimization of classification criteria for childhood-onset systemic lupus erythematosus in a multi-center Chinese cohort.Frontiers in immunology · 2025Article
- Early-onset lupus nephritis.Clinical kidney journal · 2024Review
- Does kidney biopsy in pediatric lupus patients "complement" the management and outcomes of silent lupus nephritis? Lessons learned from a pediatric cohort.Pediatric nephrology (Berlin, Germany) · 2023Observational
- An Overview of Systemic Lupus Erythematosus (SLE) Pathogenesis, Classification, and Management.Cureus · 2022Review
- Performance of the EULAR/ACR 2019 classification criteria for systemic lupus erythematous in monogenic lupus.Clinical rheumatology · 2022Article
- Validation of the 2019 EULAR/ACR classification criteria for systemic lupus erythematosus in ANA-positive Chinese patients.Therapeutic advances in musculoskeletal disease · 2022Article
- Correction to: Evaluating the performance of ACR, SLICC and EULAR/ACR classification criteria in childhood onset systemic lupus erythematosus.Pediatric rheumatology online journal · 2021Article
Corrections and comments
- Erratum issued
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe ACR 1997, SLICC 2012 and EULAR/ACR 2019 classification criteria were validated based on adult patients. To date, there are no classification criteria specific for children with SLE. The aim of the study is to compare the performance characteristics among the three SLE classification criteria (ACR-1997, SLICC-2012 and EULAR/ACR-2019) in childhood onset SLE (cSLE) cohort of Arab ethnicity from Oman.
methodsWe conducted a retrospective multicenter study in Oman of cSLE patients as cases and patients with other rheumatic disease with a positive ANA titer as controls. The cSLE cases recruited were children diagnosed with SLE before 13 years of age. Data was retrospectively collected to establish the ACR-1997, SLICC-2012 and EULAR/ACR-2019 criteria fulfilled at first visit, first year follow up and last follow up.
resultsStudy population included 113 cSLE cases (mean age at diagnosis of 7.3 ± 3.4 years with disease duration of 6.1 ± 4.6 years) and 51 controls (mean age at diagnosis 5.0 ± 3.4 with disease duration 5.7 ± 3.9). The cSLE cases had higher frequency of familial SLE than controls (38% vs 7.8%; p < 0.001). The performance measures demonstrated that EULAR/ACR-2019 criteria had the highest sensitivity (81, 88, 89%) compared to ACR 1997 (49, 57, 66%) and SLICC 2012 (76, 84,86%); while the ACR 1997 had the highest specificity (96%) compared to SLICC 2012 (94%) and EULAR/ACR 2019 (90%) at first visit, first year and last assessment. When we increased the threshold score to ≥13 rather than the traditional score ≥ 10 for ACR/EULAR 2019, there was increased specificity (96%) at the expense of lower sensitivity (76, 83, and 84%) at first visit, first year and last assessment.
conclusionIn this cSLE population, EULAR/ACR 2019 scored better at initial presentation, first year and last assessment follow up. Further multinational studies are needed to validate the appropriate cut off score for the newly proposed ACR/EULAR 2019 classification criteria in cSLE to increase early sensitivity and specificity for cSLE classification.
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