{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T09:10:31Z","timestamp":1790327431503,"version":"4.1.0"},"reference-count":15,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000005","name":"U.S. Department of Defense","doi-asserted-by":"publisher","award":["W81XWH\u201021\u20101\u20100468"],"award-info":[{"award-number":["W81XWH\u201021\u20101\u20100468"]}],"id":[{"id":"10.13039\/100000005","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to compare the performance of the Lupus Foundation of America Rapid Evaluation of Activity in Lupus (LFA\u2010REAL), British Isles Lupus Assessment Group Index (BILAG), and Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) in detecting the clinician's perception of improvement and worsening disease and identifying patients requiring treatment escalation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a prospective, observational study conducted at four centers. Adults with systemic lupus erythematosus were evaluated at a baseline and follow\u2010up visit. Disease activity was assessed using SLEDAI, BILAG, and LFA\u2010REAL at both visits by the same physician. At the follow\u2010up visit, the Clinician Global Impression of Change (CGIC) was recorded to classify patients as improved, worsened, or unchanged. Receiver operating characteristic curve analysis was used to evaluate each instrument in detecting clinician\u2010rated change gauged by CGIC with optimal cut\u2010off points determined using the Youden Index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 163 patients enrolled, 145 (89%) completed a follow\u2010up visit. Based on CGIC, 23% improved, 16% worsened, and 61% remained stable. For detecting CGIC\u2010defined improvement, LFA\u2010REAL had an area under the curve (AUC) of 0.85 (95% confidence interval [CI] 0.77\u20130.92), compared to 0.75 (95% CI 0.66\u20130.85) for BILAG and 0.74 (95% CI 0.64\u20130.84) for SLEDAI. For CGIC\u2010defined worsening, AUCs were 0.86 (95% CI 0.77\u20130.96), 0.79 (95% CI 0.67\u20130.90), and 0.76 (95% CI 0.66\u20130.87). Of those with CGIC\u2010defined worsening, eight (35%) required treatment escalation. LFA\u2010REAL identified a difference of \u226510 mm in all eight of these patients, compared to four by BILAG and two by SLEDAI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>LFA\u2010REAL showed comparable performance relative to SLEDAI and BILAG in detecting clinician\u2010rated change. There was a statistically significant advantage over SLEDAI for detection of improvement. These findings support its utility as a metric for disease activity in clinical practice and research.<\/jats:p>\n                    <jats:p>\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/acr80034-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.80034","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T14:00:42Z","timestamp":1773064842000},"page":"1414-1423","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparative Performance of\n                    <scp>LFA<\/scp>\n                    \u2010\n                    <scp>REAL<\/scp>\n                    ,\n                    <scp>SLEDAI<\/scp>\n                    , and\n                    <scp>BILAG<\/scp>\n                    for Detecting Clinically Meaningful Changes in Lupus Activity"],"prefix":"10.1002","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-9763-8209","authenticated-orcid":false,"given":"Alberto","family":"Nordmann\u2010Gomes","sequence":"first","affiliation":[{"name":"Columbia University Irving Medical Center  New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila","family":"Khalili","sequence":"additional","affiliation":[{"name":"Columbia University Irving Medical Center  New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9299-0053","authenticated-orcid":false,"given":"Cynthia","family":"Aranow","sequence":"additional","affiliation":[{"name":"Feinstein Institutes for Medical Research  Manhasset New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4061-3798","authenticated-orcid":false,"given":"Meggan","family":"Mackay","sequence":"additional","affiliation":[{"name":"Feinstein Institutes for Medical Research  Manhasset New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mimi","family":"Kim","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine  Bronx New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane","family":"Kamen","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina  Charleston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9546-1664","authenticated-orcid":false,"given":"Cristina","family":"Arriens","sequence":"additional","affiliation":[{"name":"Oklahoma Medical Research Foundation  Oklahoma City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maya","family":"Souvignier","sequence":"additional","affiliation":[{"name":"Columbia University Irving Medical Center  New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Tang","sequence":"additional","affiliation":[{"name":"Columbia University Irving Medical Center  New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Suh","sequence":"additional","affiliation":[{"name":"Columbia University Irving Medical Center  New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1151-0084","authenticated-orcid":false,"given":"Robert","family":"Clancy","sequence":"additional","affiliation":[{"name":"Columbia University Irving Medical Center  New York New 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