Systemic lupus erythematosus (SLE) severity, reflecting both disease intensity and duration, is heterogeneous making it challenging to study in administrative databases where severity may confound or mediate associations with outcomes. Garris et al. developed an administrative claims-based algorithm employing claims over a 1-year period to classify SLE severity as mild, moderate or severe. We sought to compare this administrative algorithm to a measure of SLE activity, the SLE Disease Activity Index-2000 (SLEDAI-2K) score at clinical visits. We identified 100 SLE patients followed in the Brigham and Women's Hospital (BWH) Lupus Center (in 2008-2010) with SLEDAI-2K scores at each visit over a 1-year period per person. We obtained data for the Garris algorithm for the same year per subject. We compared Garris SLE severity to the highest SLEDAI-2K in that year, with SLEDAI-2K categories of mild < 3, moderate 3-6, and severe > 6. We compared classification using weighted kappa statistics, and positive and negative predictive values (PPV, NPV). We also assessed the binary comparison of mild vs. moderate/severe. We calculated sensitivity, specificity, and McNemar's test. We analyzed 377 SLEDAI-2K assessments (mean 3.8 [SD 2.6] per subject/year). For classifying moderate/severe vs. mild SLE severity, the sensitivity was 85.7%, specificity 67.6%, PPV 81.8% and NPV 73.5%. The Garris algorithm for classifying SLE severity in administrative datasets had moderate agreement for classification of mild vs. moderate/severe SLE activity assessed by SLEDAI-2K assessments in an academic lupus center. It may be a useful tool for classifying SLE severity in administrative database studies.

中文翻译：

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SLE疾病严重程度管理算法与临床SLE疾病活动指数评分的比较。

反映疾病强度和病程的系统性红斑狼疮（SLE）严重程度是异质的，这使得在严重程度可能混淆或介导与结果关联的行政数据库中进行研究具有挑战性。Garris等。开发了一种基于行政索赔的算法，该算法使用1年以上的索赔将SLE严重程度分类为轻度，中度或严重。我们试图将这种管理算法与SLE活动的量度进行比较，SLE活动在临床就诊时的SLE疾病活动指数2000（SLEDAI-2K）得分。我们确定了100例SLE患者，这些患者在布莱根妇女医院（BWH）狼疮中心（2008-2010年）接受随访，每位患者在1年内的每次访视均获得SLEDAI-2K评分。我们获得了针对每个主题同一年的Garris算法的数据。我们将Garris SLE的严重程度与该年最高的SLEDAI-2K进行了比较，其中SLEDAI-2K类别为轻度<3，中度3-6和重度>6。我们使用加权kappa统计量以及阳性和阴性预测值（ PPV，NPV）。我们还评估了轻度与中度/重度的二元比较。我们计算了敏感性，特异性和McNemar检验。我们分析了377个SLEDAI-2K评估（每个受试者/年平均3.8 [SD 2.6]）。要对中度/重度与轻度SLE严重程度进行分类，敏感性为85.7％，特异性为67.6％，PPV为81.8％，NPV为73.5％。Garris算法在行政数据集中对SLE严重程度进行分类，在学术性狼疮中心通过SLEDAI-2K评估对轻度与中度/重度SLE活动进行分类具有中等程度的一致性。