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2016 ; 3
(1
): e000136
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Development and validation of a simple lupus severity index using ACR criteria
for classification of SLE
#MMPMID27026812
Bello GA
; Brown MA
; Kelly JA
; Thanou A
; James JA
; Montgomery CG
Lupus Sci Med
2016[]; 3
(1
): e000136
PMID27026812
show ga
OBJECTIVE: To develop a simple systemic lupus erythematosus (SLE) severity index
that requires knowledge of only American College of Rheumatology (ACR) criteria
and subcriteria. METHODS: This study used demographic, mortality and medical
records data of 1915 patients with lupus from the Lupus Family Registry and
Repository. The data were randomly split (2:1 ratio) into independent training
and validation sets. A logistic regression with ridge penalty was used to model
the probability of being prescribed major immunosuppressive drugs-a surrogate
indicator of lupus severity. ACR criteria and subcriteria were used as predictor
variables in this model, and the resulting regression coefficient estimates
obtained from the training data were used as item weightings to construct the
severity index. RESULTS: The resulting index was tested on the independent
validation dataset and was found to have high predictive accuracy for
immunosuppressive use and early mortality. The index was also found to be
strongly correlated with a previously existing severity score for lupus. In
addition, demographic factors known to influence lupus severity (eg, age of
onset, gender and ethnicity) all showed robust associations with our severity
index that were consistent with observed clinical trends. CONCLUSIONS: This new
index can be easily computed using ACR criteria, which may be among the most
readily available data elements from patient medical records. This tool may be
useful in lupus research, especially large dataset analyses to stratify patients
by disease severity, an important prognostic indicator in SLE.
free
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