New Criteria To Be Tested For Lupus Diagnosis
- SLICC revision of the ACR classification criteria for SLE. (2009).
American College of Rheumatology Abstracts 895.
What is the topic?
The American College of Rheumatology established criteria for lupus in 1982, which were most recently revised in 1997. However, as time goes by and new research is completed, it makes sense to revisit how lupus is defined.
What did the researchers hope to learn?
The researchers wanted to find out whether updating the criteria doctors use to diagnose lupus could increase the accuracy of distinguishing lupus from other overlapping diseases, so that of those patients who meet the new criteria, there are more who really have lupus (true positive) and fewer who do not (false positive).
Who was studied?
716 patients with either lupus or other disorders which are sometimes confused with lupus were studied.
How was the study conducted?
Each of the patients was evaluated by a lupus expert and their clinical features were written up and sent out as a summary to other lupus experts, each of whom gave an opinion as to whether the patient should be considered to have lupus or not. The degree of agreement on various patient descriptions was studied and discussed by the group, and the characteristics that were found to be most predictive of lupus were derived, using statistical rules and further discussions.
What did the researchers find?
The researchers found that use of the new criteria that resulted from this study increased the likelihood of accurate lupus diagnoses based on expert opinion. Although, using the old criteria, the numbers of patients that are likely to be misclassified is not large, the difference could be important in clinical trials, which are already extremely complicated to interpret for a complicated disease like lupus, so the way in which patients are chosen to participate in these trials needs to be very precise.
What were the limitations of the study?
In order to establish these new criteria, another study needs to be performed. This is called a validation study, and without this, it would be premature to replace the old criteria with the new ones.
What do the results mean for you?
Updating the criteria for lupus could support progress in understanding the disease and developing new treatments for it.