Development of a clinical chart to compute different disease activity indices for systemic lupus erythematosus

Between 1990 and 1995 a European Consensus Group carried out a multicenter study to reach agreement of the definition of disease activity in systemic lupus erythematosus (SLE). A new index, the European Consensus Lupus Activi ty Measurement (ECLAM) index, was developed. In a second phase of the study , a prospective survey aimed at validating ECLAM and 4 other scales as stea dy-state and transition indices for disease activity in SLE was completed. We present the results of this survey. A standardized clinical charr was de veloped, together with a computer program that could automatically calculat e the ECLAM score, as well as the scores for some of the disease activity s cales most widely used at present, i.e., the British Isles Lupus Assessment Group, Systemic Lupus Activity Measure, SLE Disease Activity Index, and th e SLE Index Score (SIS). With the participation of 28 centers in 15 differe nt European countries, data from 121 prospectively selected new lupus patie nts were collected. The validity of the 5 activity scales was assessed by c omparing the computed scores for each patient to a gold standard, i.e., the physician's subjective judgment on disease activity measured using a semiq uantitative scale. All the indices were found to be valid instruments for m easuring disease activity in SLE in both the steady-state and transition ph ases. The results for the various indices closely correlated with one anoth er. Thus, the computerized chart developed by the European Consensus Group offers a simple and reliable instrument to assess disease activity and coul d be used to monitor lupus patients both in clinical practice and in clinic al trials.