Abstract：
UNASSIGNED: Classification criteria for systemic lupus erythematosus (SLE) include American College of Rheumatology (ACR) 1997, Systemic Lupus Erythematosus International Collaborating Clinics (SLICC) 2012 and European Alliance of Associations for Rheumatology (EULAR)/ACR 2019 criteria. Their performance in an Asian childhood-onset SLE (cSLE) population remains unclear as the clinical manifestations differ. We aim to evaluate the diagnostic performance in a cSLE cohort in Singapore.
UNASSIGNED: Cases were physician-diagnosed cSLE, while controls were children with mixed and undifferentiated connective tissue disease that posed an initial diagnostic challenge. Data were retrospec-tively reviewed to establish the 3 criteria fulfilled at diagnosis and over time.
UNASSIGNED: The study population included 120 cSLE cases and 36 controls. At diagnosis, 102 (85%) patients fulfilled all criteria. SLICC-2012 had the highest sensitivity (97.5%, 95% confidence interval [CI] 92.3-99.5), while ACR-1997 had the highest specificity (91.7%, 95% CI 77.5-98.3). All criteria had diagnostic accuracies at more than 85%. Over time, 113 (94%) fulfilled all criteria. SLICC-2012 remained the criteria with the highest sensitivity (99.2%, 95% CI 95.4-99.9), while ACR-1997 had the highest specificity (75.0%, 95% CI 57.8-87.9). Only SLICC-2012 and ACR-1997 had more than 85% diagnostic accuracy over time. Using a cutoff score of ≥13 for EULAR/ACR-2019 criteria resulted in improved diagnostic performance.
UNASSIGNED: SLICC-2012 criteria had the highest sensitivity early in the disease course in this first study evaluating the SLE classification criteria performance in a Southeast Asian cSLE cohort, while the ACR-1997 criteria had the highest specificity. Using a cutoff score of ≥13 for EULAR/ACR-2019 improved the diagnostic performance.
UNASSIGNED: Cases were physician-diagnosed cSLE, while controls were children with mixed and undifferentiated connective tissue disease that posed an initial diagnostic challenge. Data were retrospec-tively reviewed to establish the 3 criteria fulfilled at diagnosis and over time.
UNASSIGNED: The study population included 120 cSLE cases and 36 controls. At diagnosis, 102 (85%) patients fulfilled all criteria. SLICC-2012 had the highest sensitivity (97.5%, 95% confidence interval [CI] 92.3-99.5), while ACR-1997 had the highest specificity (91.7%, 95% CI 77.5-98.3). All criteria had diagnostic accuracies at more than 85%. Over time, 113 (94%) fulfilled all criteria. SLICC-2012 remained the criteria with the highest sensitivity (99.2%, 95% CI 95.4-99.9), while ACR-1997 had the highest specificity (75.0%, 95% CI 57.8-87.9). Only SLICC-2012 and ACR-1997 had more than 85% diagnostic accuracy over time. Using a cutoff score of ≥13 for EULAR/ACR-2019 criteria resulted in improved diagnostic performance.
UNASSIGNED: SLICC-2012 criteria had the highest sensitivity early in the disease course in this first study evaluating the SLE classification criteria performance in a Southeast Asian cSLE cohort, while the ACR-1997 criteria had the highest specificity. Using a cutoff score of ≥13 for EULAR/ACR-2019 improved the diagnostic performance.
摘要：
■系统性红斑狼疮（SLE）的分类标准包括美国风湿病学会（ACR）1997，系统性红斑狼疮国际合作诊所（SLICC）2012和欧洲风湿病学协会联盟（EULAR）/ACR2019标准。由于临床表现不同，他们在亚洲儿童发作的SLE（cSLE）人群中的表现尚不清楚。我们旨在评估新加坡cSLE队列的诊断表现。
■病例是医生诊断的cSLE，而对照组是患有混合性和未分化结缔组织疾病的儿童，这些疾病构成了最初的诊断挑战。对数据进行回顾性审查，以建立诊断时和一段时间内满足的3项标准。
■研究人群包括120例cSLE病例和36例对照。诊断时,102名（85%）患者符合所有标准。SLICC-2012的灵敏度最高(97.5%，95%置信区间[CI]92.3-99.5)，而ACR-1997的特异性最高(91.7%，95%CI77.5-98.3）。所有标准的诊断准确率均超过85%。随着时间的推移,113（94%）符合所有标准。SLICC-2012仍然是敏感度最高的标准(99.2%，95%CI95.4-99.9），而ACR-1997的特异性最高(75.0%，95%CI57.8-87.9）。随着时间的推移，只有SLICC-2012和ACR-1997的诊断准确率超过85%。对EULAR/ACR-2019标准使用≥13的截止分数可改善诊断性能。
■SLICC-2012标准在本首次评估东南亚cSLE队列中SLE分类标准表现的研究中，在病程早期的敏感性最高。而ACR-1997标准的特异性最高。使用≥13分的EULAR/ACR-2019可改善诊断性能。
■病例是医生诊断的cSLE，而对照组是患有混合性和未分化结缔组织疾病的儿童，这些疾病构成了最初的诊断挑战。对数据进行回顾性审查，以建立诊断时和一段时间内满足的3项标准。
■研究人群包括120例cSLE病例和36例对照。诊断时,102名（85%）患者符合所有标准。SLICC-2012的灵敏度最高(97.5%，95%置信区间[CI]92.3-99.5)，而ACR-1997的特异性最高(91.7%，95%CI77.5-98.3）。所有标准的诊断准确率均超过85%。随着时间的推移,113（94%）符合所有标准。SLICC-2012仍然是敏感度最高的标准(99.2%，95%CI95.4-99.9），而ACR-1997的特异性最高(75.0%，95%CI57.8-87.9）。随着时间的推移，只有SLICC-2012和ACR-1997的诊断准确率超过85%。对EULAR/ACR-2019标准使用≥13的截止分数可改善诊断性能。
■SLICC-2012标准在本首次评估东南亚cSLE队列中SLE分类标准表现的研究中，在病程早期的敏感性最高。而ACR-1997标准的特异性最高。使用≥13分的EULAR/ACR-2019可改善诊断性能。
