Study of Flare Assessment in Systemic Lupus Erythematosus Based on Paper Patients

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Study of Flare Assessment in Systemic Lupus Erythematosus Based on Paper Patients

Isenberg, D. (author): University College London

Sturgess, J. (author): University College London

Allen, E. (author): University College London

Aranow, C. (author): Feinstein Institute for Medical Research

Askanase, A. (author): Columbia University

Sang-Cheol, B. (author): Hanyang University

Bernatsky, S. (author): McGill University

Bruce, I. (author): University of Manchester

Buyon, J. (author): Icahn School of Medicine at Mount Sinai

Cervera, R. (author): University of Barcelona

Clarke, A. (author): University of Calgary

Dooley, Mary Anne (author): University of North Carolina

Fortin, P. (author): Laval University

Ginzler, E. (author)

Gladman, D. (author): University of Toronto

Hanly, J. (author)

Inanc, M. (author): Istanbul University

Jacobsen, S. (author): Copenhagen University Hospital

Kamen, D. (author)

Khamashta, M. (author): King's College London

Lim, S. (author): Emory University

Manzi, S. (author)

Nived, O. (author): Lund University,Lunds universitet,Reumatologi och molekylär skelettbiologi,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Rheumatology,Section III,Department of Clinical Sciences, Lund,Faculty of Medicine

Peschken, C. (author): University of Manitoba

Petri, M. (author): Johns Hopkins University

Kalunian, K. (author): University of California, San Diego

Rahman, A. (author): University College London

Ramsey-Goldman, R. (author): Northwestern University Feinberg School of Medicine

Romero-Diaz, J. (author): Instituto Nacional de Ciencias Médicas y Nutrición

Ruiz-Irastorza, G. (author): University of the Basque Country

Sanchez-Guerrero, J. (author): University of Toronto

Steinsson, K. (author): National University Hospital of Iceland

Sturfelt, G. (author): Lund University,Lunds universitet,Reumatologi och molekylär skelettbiologi,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Rheumatology,Section III,Department of Clinical Sciences, Lund,Faculty of Medicine

Urowitz, M. (author): University of Toronto

van Vollenhoven, R. (author): Karolinska Institutet

Wallace, D. J. (author): University of California, Los Angeles

Zoma, A. (author): Hairmyres Hospital

Merrill, J. (author)

Gordon, C. (author): University of Birmingham

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(creator_code:org_t)

2017-12-08
2018
English 6 s.
In: Arthritis Care and Research. - : Wiley. - 2151-464X .- 2151-4658. ; 70:1, s. 98-103

Related links:: http://dx.doi.org/10...; show more...; https://onlinelibrar...; https://lup.lub.lu.s...; https://doi.org/10.1...; http://kipublication...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

Objective: To determine the level of agreement of disease flare severity (distinguishing severe, moderate, and mild flare and persistent disease activity) in a large paper-patient exercise involving 988 individual cases of systemic lupus erythematosus. Methods: A total of 988 individual lupus case histories were assessed by 3 individual physicians. Complete agreement about the degree of flare (or persistent disease activity) was obtained in 451 cases (46%), and these provided the reference standard for the second part of the study. This component used 3 flare activity instruments (the British Isles Lupus Assessment Group [BILAG] 2004, Safety of Estrogens in Lupus Erythematosus National Assessment [SELENA] flare index [SFI] and the revised SELENA flare index [rSFI]). The 451 patient case histories were distributed to 18 pairs of physicians, carefully randomized in a manner designed to ensure a fair case mix and equal distribution of flare according to severity. Results: The 3-physician assessment of flare matched the level of flare using the 3 indices, with 67% for BILAG 2004, 72% for SFI, and 70% for rSFI. The corresponding weighted kappa coefficients for each instrument were 0.82, 0.59, and 0.74, respectively. We undertook a detailed analysis of the discrepant cases and several factors emerged, including a tendency to score moderate flares as severe and persistent activity as flare, especially when the SFI and rSFI instruments were used. Overscoring was also driven by scoring treatment change as flare, even if there were no new or worsening clinical features. Conclusion: Given the complexity of assessing lupus flare, we were encouraged by the overall results reported. However, the problem of capturing lupus flare accurately is not completely solved.

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Rheumatology and ...

Articles in the publication: Arthritis Care a ...

By the university: Lund University; Karolinska Institutet

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Study of Flare Assessment in Systemic Lupus Erythematosus Based on Paper Patients

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