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  • Isenberg, D.University College London (author)

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

  • Article/chapterEnglish2018

Publisher, publication year, extent ...

  • 2017-12-08
  • Wiley,2018
  • 6 s.

Numbers

  • LIBRIS-ID:oai:lup.lub.lu.se:e5d53782-ade5-4d3d-81b7-ec15538e8563
  • https://lup.lub.lu.se/record/e5d53782-ade5-4d3d-81b7-ec15538e8563URI
  • https://doi.org/10.1002/acr.23252DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:137301329URI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:art swepub-publicationtype
  • Subject category:ref swepub-contenttype

Notes

  • 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.

Subject headings and genre

Added entries (persons, corporate bodies, meetings, titles ...)

  • Sturgess, J.University College London (author)
  • Allen, E.University College London (author)
  • Aranow, C.Feinstein Institute for Medical Research (author)
  • Askanase, A.Columbia University (author)
  • Sang-Cheol, B.Hanyang University (author)
  • Bernatsky, S.McGill University (author)
  • Bruce, I.University of Manchester (author)
  • Buyon, J.Icahn School of Medicine at Mount Sinai (author)
  • Cervera, R.University of Barcelona (author)
  • Clarke, A.University of Calgary (author)
  • Dooley, Mary AnneUniversity of North Carolina (author)
  • Fortin, P.Laval University (author)
  • Ginzler, E. (author)
  • Gladman, D.University of Toronto (author)
  • Hanly, J. (author)
  • Inanc, M.Istanbul University (author)
  • Jacobsen, S.Copenhagen University Hospital (author)
  • Kamen, D. (author)
  • Khamashta, M.King's College London (author)
  • Lim, S.Emory University (author)
  • Manzi, S. (author)
  • Nived, O.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(Swepub:lu)reum-oni (author)
  • Peschken, C.University of Manitoba (author)
  • Petri, M.Johns Hopkins University (author)
  • Kalunian, K.University of California, San Diego (author)
  • Rahman, A.University College London (author)
  • Ramsey-Goldman, R.Northwestern University Feinberg School of Medicine (author)
  • Romero-Diaz, J.Instituto Nacional de Ciencias Médicas y Nutrición (author)
  • Ruiz-Irastorza, G.University of the Basque Country (author)
  • Sanchez-Guerrero, J.University of Toronto (author)
  • Steinsson, K.National University Hospital of Iceland (author)
  • Sturfelt, G.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(Swepub:lu)reum-gst (author)
  • Urowitz, M.University of Toronto (author)
  • van Vollenhoven, R.Karolinska Institutet (author)
  • Wallace, D. J.University of California, Los Angeles (author)
  • Zoma, A.Hairmyres Hospital (author)
  • Merrill, J. (author)
  • Gordon, C.University of Birmingham (author)
  • University College LondonFeinstein Institute for Medical Research (creator_code:org_t)

Related titles

  • In:Arthritis Care and Research: Wiley70:1, s. 98-1032151-464X2151-4658

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