Classification Criteria for SLE 1971 ARA Criteria Sample Clauses

Classification Criteria for SLE 1971 ARA Criteria. In response to a lack of uniformity in the definition of SLE in research, the American Rheumatism Asso- ciation (ARA) released the Preliminary Criteria for the Classification of SLE in 1971 (Xxxxx et al., 1971). The panel charged with creating the SLE classification criteria devised a format similar to the previously devised rheumatoid arthritis (RA) criteria: a person would be classified as having SLE if they had at any time exhibited 4 or more of a list of 14 clinical symptoms or signs. The stated purpose of this classification xxxxx- ria was to create a uniform classification system to allow the comparison of research on the natural history, clinical management, and epidemiology of SLE. The panel emphasized that the criteria were intended for classification use, not for diagnostic use. The ARA panel solicited SLE cases and controls from 52 rheumatologists. Each rheumatologist selected 5 unequivocal SLE patients (in their own opinion), 5 “possible” SLE patients, 5 rheumatoid arthritis (RA) patients, and 5 controls (no SLE or RA) from their own patient population. Each rheumatologist then re- sponded “present” or “absent” for a list of 74 clinical signs and symptoms. (The 74 items included any sign or symptom felt by at least one member of the ARA panel to be an SLE manifestation). The criteria were published with a reported “greater than 90%” sensitivity although no external validation study had been performed. In an analysis of patients with physician-diagnosed SLE in the Stanford databank of rheumatic disease, Fries and Xxxxxx (1973) found that 57.2% of patients had four or more ARA criteria at the first visit. When cumulative findings were considered, 73.3% of SLE patients had four or more ARA criteria. The 1982 ACR criteria The ARA re-evaluated the 1971 SLE criteria to address the concerns about sensitivity and to incorporate serological measures that had not been in widespread use when the 1971 criteria were developed (Tan et al., 1982). (These criteria are now referred to as the ACR criteria after the new name of the ARA, the American College of Rheumatology.) The panel asked 18 rheumatologists to choose their next 10 SLE patients and 10 non-SLE controls (age-, race-, and sex-matched patients with non-traumatic, non-degenerative connective tissue disorders). The sensitivity and specificity of 30 combinations of items was tested. The panel reduced the number of criteria from 14 to 11, with four for mucocutaneous manifestations. Each of the non-mucoc...
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