Multicenter Delphi Exercise to Identify Important Key Items for Classifying Systemic Lupus Erythematosus

Area of Science:

• Rheumatology
• Immunology
• Clinical Medicine

Background:

• Systemic lupus erythematosus (SLE) classification requires updated criteria.
• The American College of Rheumatology and European League Against Rheumatism initiated a project to reevaluate SLE classification.

Purpose of the Study:

• To generate and select items for a new classification system for SLE.
• To establish a broadly representative view of current SLE classification approaches.

Main Methods:

• A two-step Delphi process involving international lupus expert clinicians.
• Web-based surveys were used for item generation, rating, and selection.
• 135 and 147 experts participated in item generation and reduction, respectively.

Main Results:

• 145 initial items were reduced to 40 candidate criteria for SLE classification.
• Key features identified include autoantibodies, renal, and skin manifestations.
• A majority of experts (51%) considered one organ system sufficient with specific lab features; 85% would classify SLE based on lupus nephritis alone.

Conclusions:

• A set of 40 candidate criteria for SLE classification was established through a Delphi exercise.
• This study involved the largest expert panel to date for developing SLE criteria.
• The findings provide a representative view of current SLE classification practices.