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Multicriteria decision analysis process to develop new classification criteria for systemic lupus erythematosus
Sara K Tedeschi1, Sindhu R Johnson2, Dimitrios T Boumpas3
1Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA stedeschi1@bwh.harvard.edu.
Annals of the Rheumatic Diseases
|January 30, 2019
Summary
New classification criteria for systemic lupus erythematosus (SLE) were developed using multicriteria decision analysis (MCDA). Experts achieved consensus on a provisional threshold score of 83 for SLE classification, improving diagnostic accuracy.
Area of Science:
- Rheumatology
- Clinical Immunology
- Medical Classification Systems
Background:
- Systemic lupus erythematosus (SLE) classification requires robust, evidence-based criteria.
- Previous development stages involved item generation, reduction, and hierarchical organization.
- The European League Against Rheumatism supports multiphase development of new SLE criteria.
Purpose of the Study:
- To determine relative weights for candidate SLE classification criteria using multicriteria decision analysis (MCDA).
- To establish a provisional threshold score for classifying systemic lupus erythematosus (SLE).
Main Methods:
- An expert panel evaluated 164 unique SLE cases.
- Multicriteria decision analysis (MCDA) was employed to calculate criteria weights.
- A provisional threshold score was determined based on expert consensus and case ranking.
Main Results:
- Good inter-rater reliability was achieved in scoring cases with the candidate criteria.
- The MCDA process involved 74 pairwise decisions, with recalculations to align with expert opinion.
- Expert consensus for SLE classification was reached for all cases scoring above 83.
Conclusions:
- The developed weighted criteria and provisional threshold score of 83 provide a basis for SLE classification.
- The iterative refinement of criteria definitions and weights supports a more accurate diagnostic approach.
- This study advances the development of evidence-based classification criteria for systemic lupus erythematosus.
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