Flare in Systemic Lupus Erythematosus: Lost in Translation?
Bibliographic record
Abstract
The concept of systemic lupus erythematosus (SLE) as a relapsing and remitting condition is deeply embedded in how clinicians perceive this disease. This perception arises from observations of periods of low disease activity interspersed with episodes of more active disease, which are commonly referred to as “flares.” Although the concept of flare in SLE is widely accepted in general terms, how to define and measure flare in clinical research and clinical practice is a topic of debate that remains unresolved. In this issue of The Journal of Rheumatology , Rogers et al bring a further dimension to this debate, with respect to the differences between clinicians’ and patients’ understanding of the concept of flare.1 So first, what do clinicians mean by flare? In an attempt to standardize this, especially for research purposes, a consensus definition of flare was developed under the auspices of the Lupus Foundation of America as “a measurable increase in disease activity involving new or worse clinical signs and symptoms and/or laboratory measurements. This must be considered clinically significant by the assessor with usually at least some consideration of a change or an increase in treatment.”2 The emphasis here is on increase , differentiating flare from the concept of active disease through the addition of change over time. Indeed, the consensus document includes the statement, “a flare is an increase in disease activity as compared to a previous assessment.”2 Importantly, only clinicians participated in this consensus process. For research purposes at least, flare is generally captured in registries and clinical trials using instruments such as the Safety of Estrogens in Lupus Erythematosus National Assessment–SLE Disease Activity Index (SELENA-SLEDAI) Flare Index (SFI)3 or by measuring increases in activity using the British Isles Lupus Activity Group (BILAG) index.4 Both of these include the concept … Address correspondence to Prof. E.F. Morand, Monash Medical Centre, 246 Clayton Rd, Clayton, VIC 3168, Australia. Email: eric.morand{at}monash.edu.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.058 | 0.218 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.002 |
| Bibliometrics | 0.007 | 0.006 |
| Science and technology studies | 0.003 | 0.019 |
| Scholarly communication | 0.015 | 0.025 |
| Open science | 0.005 | 0.007 |
| Research integrity | 0.013 | 0.029 |
| Insufficient payload (model declined to judge) | 0.008 | 0.004 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".