PT  - JOURNAL ARTICLE
AU  - Martin Aringer
AU  - Karen Costenbader
AU  - David Daikh
AU  - Ralph Brinks
AU  - Marta Mosca
AU  - Rosalind Ramsey-Goldman
AU  - Josef S Smolen
AU  - David Wofsy
AU  - Dimitrios T Boumpas
AU  - Diane L Kamen
AU  - David Jayne
AU  - Ricard Cervera
AU  - Nathalie Costedoat-Chalumeau
AU  - Betty Diamond
AU  - Dafna D Gladman
AU  - Bevra Hahn
AU  - Falk Hiepe
AU  - Søren Jacobsen
AU  - Dinesh Khanna
AU  - Kirsten Lerstrøm
AU  - Elena Massarotti
AU  - Joseph McCune
AU  - Guillermo Ruiz-Irastorza
AU  - Jorge Sanchez-Guerrero
AU  - Matthias Schneider
AU  - Murray Urowitz
AU  - George Bertsias
AU  - Bimba F Hoyer
AU  - Nicolai Leuchten
AU  - Chiara Tani
AU  - Sara K Tedeschi
AU  - Zahi Touma
AU  - Gabriela Schmajuk
AU  - Branimir Anic
AU  - Florence Assan
AU  - Tak Mao Chan
AU  - Ann Elaine Clarke
AU  - Mary K Crow
AU  - László Czirják
AU  - Andrea Doria
AU  - Winfried Graninger
AU  - Bernadett Halda-Kiss
AU  - Sarfaraz Hasni
AU  - Peter M Izmirly
AU  - Michelle Jung
AU  - Gábor Kumánovics
AU  - Xavier Mariette
AU  - Ivan Padjen
AU  - José M Pego-Reigosa
AU  - Juanita Romero-Diaz
AU  - Íñigo Rúa-Figueroa Fernández
AU  - Raphaèle Seror
AU  - Georg H Stummvoll
AU  - Yoshiya Tanaka
AU  - Maria G Tektonidou
AU  - Carlos Vasconcelos
AU  - Edward M Vital
AU  - Daniel J Wallace
AU  - Sule Yavuz
AU  - Pier Luigi Meroni
AU  - Marvin J Fritzler
AU  - Ray Naden
AU  - Thomas Dörner
AU  - Sindhu R Johnson
TI  - 2019 European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus
AID  - 10.1136/annrheumdis-2018-214819
DP  - 2019 Sep 01
TA  - Annals of the Rheumatic Diseases
PG  - 1151--1159
VI  - 78
IP  - 9
4099  - http://ard.bmj.com/content/78/9/1151.short
4100  - http://ard.bmj.com/content/78/9/1151.full
SO  - Ann Rheum Dis2019 Sep 01; 78
AB  - Objective To develop new classification criteria for systemic lupus erythematosus (SLE) jointly supported by the European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR).Methods This international initiative had four phases. (1) Evaluation of antinuclear antibody (ANA) as an entry criterion through systematic review and meta-regression of the literature and criteria generation through an international Delphi exercise, an early patient cohort and a patient survey. (2) Criteria reduction by Delphi and nominal group technique exercises. (3) Criteria definition and weighting based on criterion performance and on results of a multi-criteria decision analysis. (4) Refinement of weights and threshold scores in a new derivation cohort of 1001 subjects and validation compared with previous criteria in a new validation cohort of 1270 subjects.Results The 2019 EULAR/ACR classification criteria for SLE include positive ANA at least once as obligatory entry criterion; followed by additive weighted criteria grouped in seven clinical (constitutional, haematological, neuropsychiatric, mucocutaneous, serosal, musculoskeletal, renal) and three immunological (antiphospholipid antibodies, complement proteins, SLE-specific antibodies) domains, and weighted from 2 to 10. Patients accumulating ≥10 points are classified. In the validation cohort, the new criteria had a sensitivity of 96.1% and specificity of 93.4%, compared with 82.8% sensitivity and 93.4% specificity of the ACR 1997 and 96.7% sensitivity and 83.7% specificity of the Systemic Lupus International Collaborating Clinics 2012 criteria.Conclusion These new classification criteria were developed using rigorous methodology with multidisciplinary and international input, and have excellent sensitivity and specificity. Use of ANA entry criterion, hierarchically clustered and weighted criteria reflect current thinking about SLE and provide an improved foundation for SLE research.