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Table 1 Systemic lupus erythematosus disease activity measurements and their psychometric properties, administrative burden, and responsiveness to patient concerns

From: Measuring disease activity in adults with systemic lupus erythematosus: the challenges of administrative burden and responsiveness to patient concerns in clinical research

SLE disease activity measure Psychometric properties Administrative burden Responsiveness to patient care
BILAG and BILAG-2004 Reliable, valid, and sensitive to small change over time A computer is needed. Responsive
Laboratory studies are required. Fibromyalgia syndrome may complicate the assessment of lupus disease activity.
Strength: Disease activity and severity are incorporated. Time: 50 minutes  
Training is required.
Cost: $$$
Weakness: Formal training is essential for optimal performance. commercial/academic
SLAM and SLAM-R Reliable, valid, sensitive, and responsive to change over time A physician is to complete history and physical. Highly responsive
Strength: includes both disease activity and severity Laboratory studies are needed.
Time: 15 minutes
Weakness: subjective scoring by patients Training is required.
Cost: $
commercial/academic
SLEDAI, SELENA-SLEDAI Reliable, valid, sensitive, and responsive to change over time A physician is to complete history and physical. Responsive
SLEDAI-2 K
Strength: practical, most commonly used for clinical and research purposes Laboratory studies are needed. (There are no immunologic tests for the Mexican version.)
Weakness: The SLEDAI versions do not capture improving or worsening and do not include severity within an organ system. Time: 10 minutes
Training is required.
Cost: $
commercial/academic
SLE Responder Index (SRI) Reliable and valid A physician is to complete history and physical. Modest responsiveness
Strength: SRI-50 is superior to the SLEDAI-2 K in identifying patients with 50 % or greater improvement.
SRI-50 Laboratory studies are needed.
Time: 15 minutes
Training is required.
Weakness: The SRI may miss the signal toward improvement. Cost: $$
commercial/academic
Organ-specific outcome measure Reliable and valid A physician is to complete history and physical. Responsive
Strength: focused response criteria
Lupus nephritis outcome measure Weakness: Defining the optimal endpoint of organ-specific response criteria is needed. Laboratory studies are needed.
Time: 30 minutes
CLASI Long-term outcome studies are essential. Training is required.
Cost: $$
commercial/academic
The BILAG-Based Composite Lupus Assessment (BICLA) Reliable and valid A physician is to complete history and physical. Responsive
Strength: BICLA criteria require a stringent response in all body systems that are involved at baseline and require that there be no new flares in the remaining body system.
Laboratory studies are needed.
Time: 50 minutes
Training is required.
Cost: $$$
commercial/academic
Weakness: Formal training is essential for optimal performance.
SELENA-SLEDAI Flare Index (SFI) Reliable and valid A physician is to complete history and physical. Responsive
Strength: The revised SFI suggests specific clinical manifestations for each organ system and categorizes flares into mild, moderate, and severe on the basis of the treatment decision.
Laboratory studies are needed.
Time: 20 minutes
Training is required.
Cost: $$
commercial/academic
Weakness: Training is essential for optimal performance.
BILAG-2004 flare index Reliable and valid A physician is to complete history and physical. Moderate responsiveness
Strength: A strict criterion is needed to define flare.
Laboratory studies are needed.
Weakness: Scoring of worsening in the renal and hematologic domains is not yet available. Time: 50 minutes
Training is required.
Cost: $$$
commercial/academic
Lupus Foundation flare Strength: The flare must be considered clinically significant by the assessor. A physician is to complete history and physical. Responsive
Weakness: The emphasis is on clinical judgment in determining flare significance. Laboratory studies are needed.
Time: 15 minutes
Training is required.
Cost: $
A strict intention to treat is required. commercial/academic
  1. BILAG, British Isles Lupus Assessment Group; CLASI, Cutaneous Lupus Erythematosus Disease Area and Severity Index; SELENA-SLEDAI, Safety of Estrogens in Lupus National Assessment-Systemic Lupus Erythematosus Disease Activity Index; SLAM, Systemic Lupus Activity Measure; SLAM-R, Systemic Lupus Activity Measure-Revised; SLE, systemic lupus erythematosus; SLEDAI, Systemic Lupus Erythematosus Disease Activity Index; SLEDAI-2 K, Systemic Lupus Erythematosus Disease Activity Index 2000; SRI-50, SLEDAI-2000 Responder Index 50.