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) Damage Indes and the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) in the assessment of patients,vith SLE. Methods. Ten patients with SLE, representing a spectrum of damage and activity, were included, 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 according to a Youden square design. Results. The SLICC/ACR Damage Index detected 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 concordance in the SLICC/ACR Damage Index among observers, despite a wide spectrum of disease activity detected by the SLEDAI. Conclusion. Physicians from different centers are able to assess patients with SLE in a reproducible way, using the SLEDAI to assess disease activity and the SLICC/ACR Damage Index to assess accumulated damage.