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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.; Sturgess, J.; Allen, E.; Aranow, C.; Askanase, A.; Sang-Cheol, B.; Bernatsky, S.; Bruce, I.; Buyon, J.; Cervera, R.; Clarke, A.; Dooley, Mary Anne; Fortin, P.; Ginzler, E.; Gladman, D.; Hanly, J.; Inanc, M.; Jacobsen, S.; Kamen, D.; Khamashta, M.; Lim, S.; Manzi, S.; Nived, O.; Peschken, C.; Petri, M.; Kalunian, K.; Rahman, A.; Ramsey-Goldman, R.; Romero-Diaz, J.; Ruiz-Irastorza, G.; Sanchez-Guerrero, J.; Steinsson, K.; Sturfelt, G.; Urowitz, M.; van Vollenhoven, R.; Wallace, D. J.; Zoma, A.; Merrill, J.; Gordon, C.

In: Arthritis care & research, Vol. 70, No. 1, 01.01.2018, p. 98-103.

Research output: Contribution to journalArticle

Harvard

Isenberg, D, Sturgess, J, Allen, E, Aranow, C, Askanase, A, Sang-Cheol, B, Bernatsky, S, Bruce, I, Buyon, J, Cervera, R, Clarke, A, Dooley, MA, Fortin, P, Ginzler, E, Gladman, D, Hanly, J, Inanc, M, Jacobsen, S, Kamen, D, Khamashta, M, Lim, S, Manzi, S, Nived, O, Peschken, C, Petri, M, Kalunian, K, Rahman, A, Ramsey-Goldman, R, Romero-Diaz, J, Ruiz-Irastorza, G, Sanchez-Guerrero, J, Steinsson, K, Sturfelt, G, Urowitz, M, van Vollenhoven, R, Wallace, DJ, Zoma, A, Merrill, J & Gordon, C 2018, 'Study of Flare Assessment in Systemic Lupus Erythematosus Based on Paper Patients', Arthritis care & research, vol. 70, no. 1, pp. 98-103. https://doi.org/10.1002/acr.23252

APA

Isenberg, D., Sturgess, J., Allen, E., Aranow, C., Askanase, A., Sang-Cheol, B., Bernatsky, S., Bruce, I., Buyon, J., Cervera, R., Clarke, A., Dooley, M. A., Fortin, P., Ginzler, E., Gladman, D., Hanly, J., Inanc, M., Jacobsen, S., Kamen, D., ... Gordon, C. (2018). Study of Flare Assessment in Systemic Lupus Erythematosus Based on Paper Patients. Arthritis care & research, 70(1), 98-103. https://doi.org/10.1002/acr.23252

Vancouver

Isenberg D, Sturgess J, Allen E, Aranow C, Askanase A, Sang-Cheol B et al. Study of Flare Assessment in Systemic Lupus Erythematosus Based on Paper Patients. Arthritis care & research. 2018 Jan 1;70(1):98-103. https://doi.org/10.1002/acr.23252

Author

Isenberg, D. ; Sturgess, J. ; Allen, E. ; Aranow, C. ; Askanase, A. ; Sang-Cheol, B. ; Bernatsky, S. ; Bruce, I. ; Buyon, J. ; Cervera, R. ; Clarke, A. ; Dooley, Mary Anne ; Fortin, P. ; Ginzler, E. ; Gladman, D. ; Hanly, J. ; Inanc, M. ; Jacobsen, S. ; Kamen, D. ; Khamashta, M. ; Lim, S. ; Manzi, S. ; Nived, O. ; Peschken, C. ; Petri, M. ; Kalunian, K. ; Rahman, A. ; Ramsey-Goldman, R. ; Romero-Diaz, J. ; Ruiz-Irastorza, G. ; Sanchez-Guerrero, J. ; Steinsson, K. ; Sturfelt, G. ; Urowitz, M. ; van Vollenhoven, R. ; Wallace, D. J. ; Zoma, A. ; Merrill, J. ; Gordon, C. / Study of Flare Assessment in Systemic Lupus Erythematosus Based on Paper Patients. In: Arthritis care & research. 2018 ; Vol. 70, No. 1. pp. 98-103.

Bibtex Download

@article{5e3cdbb4e59e4a85a004d29053cba731,
title = "Study of Flare Assessment in Systemic Lupus Erythematosus Based on Paper Patients",
abstract = "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.",
author = "D. Isenberg and J. Sturgess and E. Allen and C. Aranow and A. Askanase and B. Sang-Cheol and S. Bernatsky and I. Bruce and J. Buyon and R. Cervera and A. Clarke and Dooley, {Mary Anne} and P. Fortin and E. Ginzler and D. Gladman and J. Hanly and M. Inanc and S. Jacobsen and D. Kamen and M. Khamashta and S. Lim and S. Manzi and O. Nived and C. Peschken and M. Petri and K. Kalunian and A. Rahman and R. Ramsey-Goldman and J. Romero-Diaz and G. Ruiz-Irastorza and J. Sanchez-Guerrero and K. Steinsson and G. Sturfelt and M. Urowitz and {van Vollenhoven}, R. and Wallace, {D. J.} and A. Zoma and J. Merrill and C. Gordon",
year = "2018",
month = jan,
day = "1",
doi = "10.1002/acr.23252",
language = "English",
volume = "70",
pages = "98--103",
journal = "Arthritis care & research",
issn = "2151-464X",
publisher = "John Wiley and Sons Inc.",
number = "1",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Study of Flare Assessment in Systemic Lupus Erythematosus Based on Paper Patients

AU - Isenberg, D.

AU - Sturgess, J.

AU - Allen, E.

AU - Aranow, C.

AU - Askanase, A.

AU - Sang-Cheol, B.

AU - Bernatsky, S.

AU - Bruce, I.

AU - Buyon, J.

AU - Cervera, R.

AU - Clarke, A.

AU - Dooley, Mary Anne

AU - Fortin, P.

AU - Ginzler, E.

AU - Gladman, D.

AU - Hanly, J.

AU - Inanc, M.

AU - Jacobsen, S.

AU - Kamen, D.

AU - Khamashta, M.

AU - Lim, S.

AU - Manzi, S.

AU - Nived, O.

AU - Peschken, C.

AU - Petri, M.

AU - Kalunian, K.

AU - Rahman, A.

AU - Ramsey-Goldman, R.

AU - Romero-Diaz, J.

AU - Ruiz-Irastorza, G.

AU - Sanchez-Guerrero, J.

AU - Steinsson, K.

AU - Sturfelt, G.

AU - Urowitz, M.

AU - van Vollenhoven, R.

AU - Wallace, D. J.

AU - Zoma, A.

AU - Merrill, J.

AU - Gordon, C.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - 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.

AB - 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.

U2 - 10.1002/acr.23252

DO - 10.1002/acr.23252

M3 - Article

AN - SCOPUS:85038126075

VL - 70

SP - 98

EP - 103

JO - Arthritis care & research

JF - Arthritis care & research

SN - 2151-464X

IS - 1

ER -

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