PDF(Pubmed)
Abstract：
UNASSIGNED: The American College of Rheumatology (ACR) 1997, Systemic Lupus International Collaborating Clinics (SLICC) 2012, and European League Against Rheumatism (EULAR)/ACR 2019 SLE criteria are often used to classify patients with adult-onset and childhood-onset systemic lupus erythematosus (SLE) in clinical practice because there are currently no diagnostic criteria for SLE. However, there is scarce evidence regarding which criteria are best for diagnosing patients with adult-onset and childhood-onset SLE.
UNASSIGNED: We searched Medline and Scopus databases for English-language articles from inception through October 2021. Data were extracted from the included publications by two independent reviewers. We performed bivariate meta-analysis with a random-effects model to pool diagnostic parameters. Meta-regression and subgroup analyses were performed to explore heterogeneity sources. We used network meta-analysis to compare diagnosis performance among the three criteria and ranked them in descending order. Publication bias was assessed using Deeks\' funnel plot.
UNASSIGNED: We included 29 studies for systematic review and meta-analysis. Of these, 18 studies involved adult-onset SLE and 11 studies involved childhood-onset SLE. The pooled sensitivities of the three criteria for diagnosis of adult-onset SLE were comparable between SLICC 2012 and EULAR/ACR 2019 [95.86, 95% confidence interval (CI) 92.28-97.81 vs. 94.79, 95% CI 92.03-96.63]; pooled specificity was highest in ACR 1997 (92.24, 95% CI 87.06-95.46). In childhood-onset SLE, pooled sensitivity was highest in SLICC 2012 (93.76, 95% CI 89.45-96.39), and pooled specificity was highest in ACR 1997 (95.89, 95% CI 91.73-98.00). In network meta-analysis, the pooled diagnostic odds ratio ranked highest for EULAR/ACR 2019 (131.570, 95% CI 61.50-281.47) in adult-onset SLE and ranked highest for SLICC 2012 (191.07, 95% CI 76.06-480.01) in childhood-onset SLE. Deeks\' funnel plot showed no publication bias.
UNASSIGNED: We found that the diagnostic performance of the ACR 1997, SLICC 2012, and EULAR/ACR 2019 criteria differed between adult-onset and childhood-onset SLE. EULAR/ACR 2019 performed best for adult-onset SLE and SLICC 2012 was best for childhood-onset SLE in classifying patients with SLE.
UNASSIGNED: [www.ClinicalTrials.gov], identifier [CRD420 21281586].
UNASSIGNED: We searched Medline and Scopus databases for English-language articles from inception through October 2021. Data were extracted from the included publications by two independent reviewers. We performed bivariate meta-analysis with a random-effects model to pool diagnostic parameters. Meta-regression and subgroup analyses were performed to explore heterogeneity sources. We used network meta-analysis to compare diagnosis performance among the three criteria and ranked them in descending order. Publication bias was assessed using Deeks\' funnel plot.
UNASSIGNED: We included 29 studies for systematic review and meta-analysis. Of these, 18 studies involved adult-onset SLE and 11 studies involved childhood-onset SLE. The pooled sensitivities of the three criteria for diagnosis of adult-onset SLE were comparable between SLICC 2012 and EULAR/ACR 2019 [95.86, 95% confidence interval (CI) 92.28-97.81 vs. 94.79, 95% CI 92.03-96.63]; pooled specificity was highest in ACR 1997 (92.24, 95% CI 87.06-95.46). In childhood-onset SLE, pooled sensitivity was highest in SLICC 2012 (93.76, 95% CI 89.45-96.39), and pooled specificity was highest in ACR 1997 (95.89, 95% CI 91.73-98.00). In network meta-analysis, the pooled diagnostic odds ratio ranked highest for EULAR/ACR 2019 (131.570, 95% CI 61.50-281.47) in adult-onset SLE and ranked highest for SLICC 2012 (191.07, 95% CI 76.06-480.01) in childhood-onset SLE. Deeks\' funnel plot showed no publication bias.
UNASSIGNED: We found that the diagnostic performance of the ACR 1997, SLICC 2012, and EULAR/ACR 2019 criteria differed between adult-onset and childhood-onset SLE. EULAR/ACR 2019 performed best for adult-onset SLE and SLICC 2012 was best for childhood-onset SLE in classifying patients with SLE.
UNASSIGNED: [www.ClinicalTrials.gov], identifier [CRD420 21281586].
摘要：
UNASSIGNED：美国风湿病学会（ACR）1997，系统性狼疮国际合作诊所（SLICC）2012和欧洲抗风湿病联盟（EULAR）/ACR2019SLE标准通常用于对成人发作和儿童发作系统性红斑狼疮（SLE）患者进行分类，因为目前尚无SLE的诊断标准。然而,关于哪种标准最适合诊断成年型和儿童期型SLE患者的证据很少.
UNASSIGNED：我们在Medline和Scopus数据库中搜索了从成立到2021年10月的英文文章。数据由两名独立审稿人从所包括的出版物中提取。我们使用随机效应模型进行了双变量荟萃分析，以汇集诊断参数。进行Meta回归和亚组分析以探索异质性来源。我们使用网络荟萃分析来比较三个标准之间的诊断性能，并按降序排列它们。使用Deeks漏斗图评估发表偏倚。
UASSIGNED：我们纳入了29项研究进行系统评价和荟萃分析。其中,18项研究涉及成人发作性SLE，11项研究涉及儿童发作性SLE。SLICC2012和EULAR/ACR2019之间诊断成人发作性SLE的三种标准的合并敏感性相当[95.86，95％置信区间（CI）92.28-97.81vs.94.79,95%CI92.03-96.63];合并特异性在ACR1997中最高(92.24,95%CI87.06-95.46)。在儿童发作的SLE中，2012年SLICC的合并敏感性最高(93.76，95%CI89.45-96.39)，在ACR1997中，合并特异性最高（95.89，95％CI91.73-98.00）。在网络荟萃分析中，在成人发作性SLE中,EULAR/ACR2019的汇总诊断比值比最高(131.570,95%CI61.50-281.47),在儿童发作性SLE中,SLICC2012的汇总诊断比值比最高(191.07,95%CI76.06-480.01).Deeks漏斗图没有发表偏倚。
未经评估：我们发现ACR1997、SLICC2012和EULAR/ACR2019标准的诊断性能在成人发作和儿童发作SLE之间存在差异。在SLE患者分类方面，EULAR/ACR2019对成人发作的SLE表现最佳，SLICC2012对儿童发作的SLE表现最佳。
未经批准：[www.ClinicalTrials.gov],标识符[CRD42021281586]。
UNASSIGNED：我们在Medline和Scopus数据库中搜索了从成立到2021年10月的英文文章。数据由两名独立审稿人从所包括的出版物中提取。我们使用随机效应模型进行了双变量荟萃分析，以汇集诊断参数。进行Meta回归和亚组分析以探索异质性来源。我们使用网络荟萃分析来比较三个标准之间的诊断性能，并按降序排列它们。使用Deeks漏斗图评估发表偏倚。
UASSIGNED：我们纳入了29项研究进行系统评价和荟萃分析。其中,18项研究涉及成人发作性SLE，11项研究涉及儿童发作性SLE。SLICC2012和EULAR/ACR2019之间诊断成人发作性SLE的三种标准的合并敏感性相当[95.86，95％置信区间（CI）92.28-97.81vs.94.79,95%CI92.03-96.63];合并特异性在ACR1997中最高(92.24,95%CI87.06-95.46)。在儿童发作的SLE中，2012年SLICC的合并敏感性最高(93.76，95%CI89.45-96.39)，在ACR1997中，合并特异性最高（95.89，95％CI91.73-98.00）。在网络荟萃分析中，在成人发作性SLE中,EULAR/ACR2019的汇总诊断比值比最高(131.570,95%CI61.50-281.47),在儿童发作性SLE中,SLICC2012的汇总诊断比值比最高(191.07,95%CI76.06-480.01).Deeks漏斗图没有发表偏倚。
未经评估：我们发现ACR1997、SLICC2012和EULAR/ACR2019标准的诊断性能在成人发作和儿童发作SLE之间存在差异。在SLE患者分类方面，EULAR/ACR2019对成人发作的SLE表现最佳，SLICC2012对儿童发作的SLE表现最佳。
未经批准：[www.ClinicalTrials.gov],标识符[CRD42021281586]。
