Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

First EHR Algorithm Will Help Identify SLE Patients

Arthritis Care Res; ePub 2017 Apr 10; Barnado, et al

Researchers developed and validated the first electronic health record (EHR) algorithm that incorporates laboratory values and medications with the systemic lupus erythematosus (SLE) Internal Classification of Diseases, Ninth Revision (ICD-9) code to accurately identify patients with SLE, according to a recent study. They used Vanderbilt's Synthetic Derivative, a de-identified version of the EHR, with 2.5 million subjects, selecting all individuals with at least 1 SLE ICD-9 code, yielding 5,959 individuals. In order to create a training set, 200 subjects were randomly selected for chart review. A subject was defined as a case if diagnosed with SLE by a rheumatologist, nephrologist, or dermatologist. They found:

  • The algorithm with the highest positive predictive values at 95% in the training set and 91% in the validation set was 3 or more counts of the SLE ICD-9 code, antinuclear antibody-positive, and ever use of both disease-modifying antirheumatic drugs and steroids, while excluding individuals with systemic sclerosis and dermatomyositis ICD-9 codes.


Barnado A, Casey C, Carroll RJ, Wheless L, Denny JC, Crofford LJ. Developing electronic health record algorithms that accurately identify patients with systemic lupus erythematosus. [Published online ahead of print April 10, 2017]. Arthritis Care Res. doi:10.1002/acr.22989.

This Week's Must Reads

Patient Global Assessment Discordance in RA vs OA, Rheumatol Int; ePub 2018 Oct 6; Castrejon, et al

Chronic Lung Disease, RA, and Impact on Survival , Clin Rheumatol; ePub 2018 Oct 2; England, et al

RA and Systemic Sclerosis Share Similar Impairments, Disabil Rehab; 2018 Oct; Poole, New, et al

Synovial Hypertrophy With/Without Doppler Activity , Arthritis Res Ther; ePub 2018 Oct 3; Tersley, et al

Cortical Interruptions in Finger Joints in RA, J Bone Miner Res; 2018 Sep; Peters, et al

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Patients with SSc and Pulmonary Hypertension Risk, J Rheumatol; ePub 2018 Oct 1; Hsu, Chung, et al

Improving Vaccination Rates in Patients with SLE, J Rheumatol; ePub 2018 Sep 1; Garg, Tsagaris, et al

Statins and Systemic Autoimmune Rheumatic Disease, J Rheumatol; ePub 2018 Sep 1; Jorge, Lu, et al

Patient-reported Outcomes Predict Mortality in SLE , Arthritis Care Res; ePub 2018 Aug 24; Azizoddin, et al

Arthritis Helplessness Index Valid Measure for SLE, Lupus; ePub 2018 Aug 15; Gholizadeh, et al