The diagnosis and monitoring of SLE in clinic (n = 155 responders).
| Questionnaire Items | Mode (% responders) | Strategies (% responders) |
|---|---|---|
| Use revised ACR 1997 criteria for diagnosis | Usually (39) | Always (35), sometimes (15), never (10) |
| Ranking of most common organ manifestations of SLE in clinical practice | Musculoskeletal (41) | Mucocutaneous (26), fatigue (24), renal (6), fibromyalgia (4) |
| Laboratory investigations for initial patient visit | CBC (100) | > 75% responders: creatinine (99), urinalysis (99), WBC and differential (98), dsDNA (96), ANA (96), antibodies against extractable nuclear antigens (95), complement (C3/C4 or functional assay; 94), liver enzymes (91), CRP (86), ESR (84) 11–74% responders: anticardiolipin/antiphospholipid antibodies (64), LAC/inhibitor (58), INR/PTT (49), urine protein:creatinine ratio (47), hepatitis B/C (39), quantitative immunoglobulins (35), anti-β2-GPI (22), CH50 or CH100 (15), other (17) ≤ 10% responders: 24-h urine protein (9), ANCA (8), 24-h urine creatinine (7), HIV (5) |
| Tests always used to evaluate disease activity, damage, or comorbidity on a regular basis | Swollen joint count (77) | 50–75% responders: tender joint count (70), BMD (56) 11–50% responders: PGA (42), PtGA (31), SLEDAI (any version; 16), other (14), SLICC/ACR Damage Index (12) ≤ 10% responders: SLAM (2), BILAG (any version; 1), Charlson Comorbidity Index (1) |
| Tests used to monitor disease activity over time | CBC (98) | 75–98% responders: creatinine (97), WBC differential (95), urinalysis (94), complement C3, C4 or functional assay (82); 50–75% responders: CRP (75), ESR (72), dsDNA (72), liver enzymes (59); 10–50% responders: urine protein: creatinine ratio (44), ANA (18), antibodies against nuclear antigens (17), 24-h urine protein (14), anticardiolipin/antiphospholipid antibodies (14), INR/PTT (11); ≤ 10%: LAC/inhibitor (10), quantitative immunoglobulins (10), other (9), 24-h urine creatinine (8), CH50 or CH100 (7), anti-β2-GPI (4), ANCA (1), hepatitis B/C (0), HIV (0) |
| Frequency of monitoring disease activity with laboratory studies in a patient with stable SLE | Every 6 months (39) | Every 3–4 months (35), once a year (12), every 2–3 mos (10), every month (1), no formal laboratory monitoring (1) |
SLE: systemic lupus erythematosus; ACR: American College of Rheumatology; CBC: complete blood count; WBC: white blood cell (count); ANA: antinuclear antibody; CRP: C-reactive protein; ESR: erythrocyte sedimentation rate; LAC: lupus anticoagulant; anti-β2-GPI: anti-ß2-glycoprotein I; INR/PTT: internationalized normalized ratio/prothrombin time; ANCA: antineutrophil cytoplasmic antibodies; HIV: human immunodeficiency virus; BMD: bone mineral density; PGA: physician’s global assessment; PtGA: patient’s global assessment; SLEDAI: Systemic Lupus Erythematosus Disease Activity Index; SLICC: Systemic Lupus International Collaborating Clinics; SLAM: Systemic Lupus Activity Measure; BILAG: British Isles Lupus Assessment Group index.