Objective. To determine whether Systemic Lupus Erythematosus Disease Activi
ty Index (SLEDAI) scores correlate with the clinician's impression of level
of disease activity.
Methods. In total, 230 patients with SLE followed at the University of Toro
nto Lupus Clinic who had 5 visits 3 months apart in 1992-93 were studied. A
t each visit a standard protocol was completed. A clinician who did not kno
w the patients or their SLEDAI scores evaluated each patient, record and as
signed a clinical activity level. "Flare" was defined by new or increased t
herapy for active disease, an expression of concern, or use of the term "fl
are" in the physician's notes. The SLEDAI score was calculated from the dat
abase.
Results. SLEDAI scores described a range of clinical activity as recognized
by the clinician. Median SLEDAI scores ranged from 2 (inactive disease) to
8 (persistently active or flare). When the clinician assessed the patient
to be improved, the median SLEDAI score decreased by 2, When the clinician
assessed that the patient was experiencing a flare, the SLEDAI score increa
sed by a median of 4.
Conclusion. Based on our data we propose the following outcomes for patient
s with SLE: flare, an increase in SLEDAI > 3; improvement is a reduction in
SLEDAI of > 3; persistently active disease is change in SLEDAI +/- 3; and
remission a SLEDAI of 0. These outcomes will allow a more complete descript
ion of a patient's response to therapeutic intervention in a responder inde
x.