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• W4379649474 abstract "Background The Systemic Lupus Erythematosus Disease Activity Score (SLE-DAS) has been recently developed and validated, providing improved accuracy and sensitivity for changes in SLE disease activity in comparison to SLE Disease Activity Index 2000 (SLEDAI-2K) [1] . New recommendations to standardize the Physician Global Assessment (PGA) scoring may improve its reliability [2] . Objectives To assess the intra- and interrater reliability of SLE-DAS, SLEDAI-2K and PGA for measuring SLE disease activity. Methods A set of 24 clinical vignettes were abstracted, each from a real clinical visit of patients followed at an academic lupus clinic. These vignettes were selected to include a wide spectrum of SLE manifestations, organ-system involvements, and global severity of disease activity. Abstracted data were presented in a standardized format, including demographic, past medical history, current clinical picture and treatment, laboratory, and other workup assessments. A group of 19 raters were recruited as a random multicenter sample of Rheumatologists. All raters completed a preliminary training session on scoring rules for SLE-DAS, SLEDAI-2K and PGA. Each rater scored each clinical vignette with SLE-DAS, SLEDAI-2K, and PGA through an online survey. The scoring was repeated in a second round 7-14 days after the first one. The clinical vignettes were randomly ordered for each round. Inter and intra-rater reliability of each instrument was estimated using the intraclass correlation coefficient (ICC) with 95% confidence intervals (95%CI), based on single-measurement, absolute agreement, with a two-way random effect or two-way mixed-effects model, respectively. Results The 19 raters included 8 rheumatologists and 11 rheumatology trainees from 11 hospitals, with a mean of 12.1±7.1 and 3.6±0.5 years of rheumatology practice, respectively, and 78.9% of the participants assess ≤5 SLE patients per week in their regular clinical practice. The 24 clinical vignettes included 83.3% female patients, with a mean of 36.5±17.9 years of age. Active SLE organ involvement included: skin rashes (20.8%); arthritis (12.5%); nephritis (12.5%); thrombocytopenia (12.5%); cardiac/pulmonary involvement (12.5%); mucocutaneous vasculitis (8.3%); serositis (8.3%); neuropsychiatric lupus (8.3%). Systemic vasculitis, myositis, alopecia, hemolytic anemia, and leukopenia were each present in 4.2% of the vignettes. Hypocomplementemia and/or high anti-dsDNA were present in 75.0%. Twenty-one percent of the cases were in remission. All raters completed the survey, totaling 912 case assessments. Scores attributed by the raters ranged from 0.37 to 49.53 in SLE-DAS, 0 to 24 in SLEDAI-2K, and 0.0 to 3.0 in PGA. The interrater reliability was good for SLE-DAS and SLEDAI-2K, and moderate for PGA. The intra-rater reliability was excellent for SLE-DAS, and good for SLEDAI-2K and PGA (Table 1). Table 1: Interrater and intra-rater reliability of SLE-DAS, SLEDAI-2K and PGA. ICC (95%CI) Interrater reliability Intra-rater reliability SLE-DAS 0.877 (0.807-0.934) 0.908 (0.891-0.923) SLEDAI-2K 0.812 (0.717-0.896) 0.892 (0.871-0.909) PGA 0.704 (0.578-0.828) 0.900 (0.881-0.916) CI: confidence interval; ICC: intraclass correlation coefficient. Conclusion SLE-DAS presents high intra- and interrater reliability for measuring SLE disease activity. The high reliability of SLE-DAS is an important quality both in clinical practice and research, allowing consistent scoring among different clinicians including those who are not SLE experts. References [1] Jesus D, Matos A, Henriques C, et al. Derivation and validation of the SLE Disease Activity Score (SLE-DAS): a new SLE continuous measure with high sensitivity for changes in disease activity. Ann Rheum Dis 2019;78:365-71. [2] Piga M, Chessa E, Morand EF, et al. Physician Global Assessment International Standardisation Consensus in Systemic Lupus Erythematosus: the PISCOS study. Lancet Rheumatol 2022;4:e441-e449. Acknowledgements Beatriz Mendes and Carolina Mazeda contributed equally and share first authorship. Disclosure of Interests None Declared." @default.
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• W4379649474 date "2023-05-30" @default.
• W4379649474 modified "2023-10-17" @default.
• W4379649474 title "POS1520 RELIABILITY STUDY OF THE SLE-DAS, SLEDAI-2K AND PGA INSTRUMENTS FOR MEASURING SLE DISEASE ACTIVITY" @default.
• W4379649474 doi "https://doi.org/10.1136/annrheumdis-2023-eular.4856" @default.
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