{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T21:10:59Z","timestamp":1777929059636,"version":"3.51.4"},"reference-count":55,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T00:00:00Z","timestamp":1714003200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lupus"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Constitutional symptoms (fatigue, lymphadenopathy, and weight loss) are not included in the SLE disease activity index-2000 (SLEDAI-2K). In this pilot study, we assessed the concurrent and construct validity of a revised SLEDAI-2K (SLED-R) that included these symptoms with the original SLEDAI-2K (SLED-O), using the physician global assessment of disease activity (PGA) as the reference.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Our revised SLED-R substituted the SLED-O\u2019s fever descriptor with a constitutional descriptor that included fever, fatigue, lymphadenopathy, and\/or weight loss. SLED-O, SLED-R, PGA and patient global assessment (PtGA) scores were collected prospectively. Bland-Altman correlations for repeated measures were calculated and Meng\u2019s z-test was used to compare correlations between dependent and overlapping correlation coefficients. Associations between constitutional symptoms and disease activity measures were analyzed using Mann-Whitney U, Kruskal-Wallis, Chi-square tests and repeated measures correlations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>1123 SLED-O, SLED-R, PGA, and 1066 PtGA were collected in 239 subjects. The new descriptor was scored in 45 subjects (18.8%) and 92 instances (8.1%), while the original descriptor, fever, was scored in only 4 subjects (1.7%) and 5 instances (0.4%). Mean SLED-O, PGA and PtGA scores were higher when the constitutional descriptor was scored versus not ( p &lt; .001). The correlation between SLED-R and PGA was marginally higher than between SLED-O and PGA ( p &lt; .001). Fatigue contributed most to this increase ( p = .001) and associated with both higher PGA and PtGA scores ( p &lt; .001). Mean SLED-O and PGA scores were higher when \u22651 constitutional symptom(s) were scored versus not ( p &lt; .002). Correlations between PGA and PtGA when the new descriptor was scored versus not were similar ( p = .860). The frequency of concordance between PGA and PtGA was lower when the new descriptor was scored (55%) versus not (72.5%), with PGA &gt; PtGA when the new descriptor was scored ( p &lt; .001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The addition of constitutional symptoms to SLEDAI-2K, particularly fatigue, resulted in a marginal increase in its correlation with PGA, and new constitutional symptoms associated with higher SLED-O and PGA scores. As fatigue is subjective and difficult to attribute to SLE, its validity and inter-rater reliability in scoring remains uncertain. The clinical utility of SLED-R remains unclear, and further studies of its validity and reliability are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09612033241249785","type":"journal-article","created":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T22:49:36Z","timestamp":1714085376000},"page":"840-850","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Addition of constitutional symptoms to the SLEDAI-2K improves overall disease activity assessment: A pilot study"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3154-9648","authenticated-orcid":false,"given":"Erik W","family":"Anderson","sequence":"first","affiliation":[{"name":"Institute of Molecular Medicine, The Feinstein Institutes for Medical Research, Manhasset, NY, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marissa","family":"Sansone","sequence":"additional","affiliation":[{"name":"Divison of Rheumatology, Jersey City Medical Center, Jersey City, NJ, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bhakti","family":"Shah","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Northwell Health, Manhasset, NY, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Myriam","family":"Kline","sequence":"additional","affiliation":[{"name":"Biostatistics Unit, Office of Academic Affairs, Northwell Health, New Hyde Park, NY, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2609-7974","authenticated-orcid":false,"given":"Giovanni","family":"Franchin","sequence":"additional","affiliation":[{"name":"Institute of Molecular Medicine, The Feinstein Institutes for Medical Research, Manhasset, NY, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia","family":"Aranow","sequence":"additional","affiliation":[{"name":"Institute of Molecular Medicine, The Feinstein Institutes for Medical Research, Manhasset, NY, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meggan","family":"Mackay","sequence":"additional","affiliation":[{"name":"Institute of Molecular Medicine, The Feinstein Institutes for Medical Research, Manhasset, NY, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,4,25]]},"reference":[{"key":"bibr1-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-015-0702-6"},{"key":"bibr2-09612033241249785","volume-title":"Kelley and firestein\u2019s textbook of rheumatology","author":"Firestein GS","year":"2017","edition":"10"},{"key":"bibr3-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1007\/BF02230354"},{"key":"bibr4-09612033241249785","doi-asserted-by":"publisher","DOI":"10.14740\/jocmr2717w"},{"key":"bibr5-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1177\/147323000303100415"},{"key":"bibr6-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1002\/acr.24395"},{"key":"bibr7-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-323-47927-1.00032-3"},{"key":"bibr8-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1964.03070150014003"},{"key":"bibr9-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2017.105"},{"key":"bibr10-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1002\/art.23113"},{"key":"bibr11-09612033241249785","unstructured":"Lupus and Allied Diseases Association, Lupus Foundation of America, Lupus Research Alliance. Lupus: patient voices. Report on externally-led patient-focused drug development meeting: September 25, 2017. 2018. URL: http:\/\/www.nolupus.org\/LupusPatientVoicesFINAL.pdf"},{"key":"bibr12-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1191\/096120300678828046"},{"key":"bibr13-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/39.11.1249"},{"key":"bibr14-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23794"},{"key":"bibr15-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-021-00692-1"},{"key":"bibr16-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1007\/s12026-015-8716-3"},{"key":"bibr17-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1136\/lupus-2016-000186"},{"key":"bibr18-09612033241249785","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.181338"},{"key":"bibr19-09612033241249785","first-page":"e2098","volume":"10","author":"Timlin H","year":"2018","journal-title":"Cureus"},{"key":"bibr20-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1002\/art.40674"},{"key":"bibr21-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1177\/0961203318776093"},{"key":"bibr22-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780350606"},{"key":"bibr23-09612033241249785","first-page":"288","volume":"29","author":"Gladman DD","year":"2002","journal-title":"J Rheumatol"},{"key":"bibr24-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780340802"},{"key":"bibr25-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keaa383"},{"key":"bibr26-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2019-216753"},{"key":"bibr27-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1002\/art.24698"},{"key":"bibr28-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2015-207726"},{"key":"bibr29-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1136\/lupus-2021-000538"},{"key":"bibr30-09612033241249785","first-page":"1967","volume":"30","author":"Yen JC","year":"2003","journal-title":"J Rheumatol"},{"key":"bibr31-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1177\/0961203309345748"},{"issue":"3","key":"bibr32-09612033241249785","first-page":"iii61","volume":"66","author":"Petri M","year":"2007","journal-title":"Ann Rheum Dis"},{"key":"bibr33-09612033241249785","first-page":"664","volume":"27","author":"Ward MM","year":"2000","journal-title":"J Rheumatol"},{"key":"bibr34-09612033241249785","first-page":"1934","volume":"31","author":"Uribe AG","year":"2004","journal-title":"J Rheumatol"},{"key":"bibr35-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1177\/0961203317722412"},{"key":"bibr36-09612033241249785","doi-asserted-by":"publisher","DOI":"10.2147\/PPA.S111725"},{"key":"bibr37-09612033241249785","first-page":"635","volume":"35","author":"Goligher EC","year":"2008","journal-title":"J Rheumatol"},{"key":"bibr38-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1191\/096120399680411362"},{"key":"bibr39-09612033241249785","first-page":"675","volume":"27","author":"Neville C","year":"2000","journal-title":"J Rheumatol"},{"key":"bibr40-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-020-02334-5"},{"key":"bibr41-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780400928"},{"key":"bibr42-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2010.02.004"},{"key":"bibr43-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/59.6.M633"},{"key":"bibr44-09612033241249785","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.180831"},{"key":"bibr45-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1177\/0961203309346505"},{"key":"bibr46-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa051135"},{"key":"bibr47-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1007\/s40744-017-0063-5"},{"key":"bibr48-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.310.6977.446"},{"key":"bibr49-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23573"},{"key":"bibr50-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1177\/09612033211052485"},{"key":"bibr51-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1007\/s40744-021-00374-0"},{"key":"bibr52-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1177\/09612033211005014"},{"key":"bibr53-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2017-eular.3710"},{"key":"bibr54-09612033241249785","first-page":"1467","volume":"77","author":"Nasa Y","year":"2018","journal-title":"Ann Rheum Dis"},{"key":"bibr55-09612033241249785","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23183"}],"container-title":["Lupus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09612033241249785","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/09612033241249785","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09612033241249785","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T23:27:57Z","timestamp":1777678077000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/09612033241249785"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,25]]},"references-count":55,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,7]]}},"alternative-id":["10.1177\/09612033241249785"],"URL":"https:\/\/doi.org\/10.1177\/09612033241249785","relation":{},"ISSN":["0961-2033","1477-0962"],"issn-type":[{"value":"0961-2033","type":"print"},{"value":"1477-0962","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,25]]}}}