THE RELIABILITY OF THE SYSTEMIC LUPUS-INTERNATIONAL-COLLABORATING-CLINICS AMERICAN-COLLEGE-OF-RHEUMATOLOGY DAMAGE INDEX IN PATIENTS WITH SYSTEMIC LUPUS-ERYTHEMATOSUS

Objective. To test the reliability of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Da mage Indes and the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) in the assessment of patients,vith SLE. Methods. Ten patient s with SLE, representing a spectrum of damage and activity, were inclu ded, Each patient was examined by 6 of 10 physicians from 5 countries, representing 10 lupus clinics. The SLICC/ACR Damage Indes was used to assess accumulated damage, and the SLEDAI was used to assess disease activity, The order of the patients and physicians was randomized acco rding to a Youden square design. Results. The SLICC/ACR Damage Index d etected differences among patients (P <0.001). There was no detectable observer difference (P=0.933), and there was no order effect (P=0.261 ). Similar results were obtained with the SLEDAI. There was concordanc e in the SLICC/ACR Damage Index among observers, despite a wide spectr um of disease activity detected by the SLEDAI. Conclusion. Physicians from different centers are able to assess patients with SLE in a repro ducible way, using the SLEDAI to assess disease activity and the SLICC /ACR Damage Index to assess accumulated damage.