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Good Positive and Negative Likelihood Ratios

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Systemic Lupus Erythematosis: Likelihood Ratios

Introduction: None written.

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Tags: Autoimmune Tag this Diagnosis.

The likelihood ratios of findings for Systemic Lupus Erythematosis are listed below. See the left navigation bar to change the display.

Good Positive and Negative Likelihood Ratios

Finding +LR-LR Comments, Study
ANA Edit 9.90

specificity depends on age and gender of controls (higher false -ve in women, elderly)

Study: Am Fam Physician. 2002 Mar 15;65(6):1073-80. PMID: 11925083

ACR Criteria Edit 910.1

**For specificity versus non-SLE rheumatologic disoders**

Most recent are 1997 ACR criteria, which per PMID 15922144 have not been validated. Validation has been done for the 1982 criteria (differences noted at bottom).

Criteria: >=4/11 of the following

  • Malar rash
  • Discoid rash
  • Photosensitivity
  • Oral ulcers
  • Arthritis
  • Serositis
  • Renal dysfunction
  • Neurological dysfunction
  • Hematologic dysfunction
  • Immunologic dysfunction (** changes here: LE cells removed and anticardiolipin/lupus anticoagulant added)
  • Positive ANA
  • For full details of each criterion, see the references, especially PMID 15922144.

    Study: Arthritis Rheum. 1985 Jun;28(6):715. PMID: 3890870

    Arthritis Rheum. 1985 Jun;28(6):620-3. PMID: 4004972

    Poorly Diagnostic Findings

    Finding +LR-LR Comments, Study
    Anti-dsDNA Edit Sensitivity = 60%

    high titers. Specificity not listed here, but is supposedly high.

    Also correlates with disease activity, especially nephritis.

    Study: Am Fam Physician. 2002 Mar 15;65(6):1073-80. PMID: 11925083

    Anti-Smith Edit Sensitivity = 25%

    Specificity not listed here, but reportedly high.

    Study: Am Fam Physician. 2002 Mar 15;65(6):1073-80. PMID: 11925083

    Serositis Edit Sensitivity = 18%

    ACR criterion: (A) Pleuritis: convincing history of pleuritic pain or rub heard by a physician or evidence of pleural effusion

    or

    (B) Pericarditis: documented by ECG or rub or evidence of pericardial effusion

    Study: Rheum Dis Clin North Am. 2005 May;31(2):245-54, vi. PMID: 15922144