PROPOSALS FOR DEFINITIONS OF MODERATE AND SEVERE DISEASE ACTIVITY IN SYSTEMIC LUPUS ERYTHEMATOSUS. IMPACT ON FLARES, QUALITY OF LIFE, DAMAGE ACCRUAL, HOSPITALIZATIONS AND MORTALITY
Bibliographic record
Abstract
PV199 / #53 Poster Topic: AS23 - SLE-Diagnosis, Manifestations, & Outcomes Background/Purpose To propose a definition for moderate disease activity state (MODAS) and severe disease activity state (SEDAS) in SLE and using the RELESSER-PROS cohort to describe the prevalence of both states of activity and to analyze the impact of this categorization on mortality, organ damage, flares, hospital admissions and health-related quality of life (HRQoL) Methods We used data from the prospective phase of RELESSER (RELESSER-PROS), the SLE register of the Spanish Society of Rheumatology. MODAS and SEDAS definitions are based on: cSLEDAI, presence of severe manifestations and PGA. MODAS was defined as the presence of at least 1 of the following conditions: <4 cSLEDAI < 8 or 1< PGA < 2 (without severe clinical manifestations); and SEDAS: SLEDAIc >8 or PGA > 2 or the presence of severe SLEDAI and Non-SLEDAI manifestations. We analyzed the impact of remaining in MODAS or SEDAS in terms of several robust outcomes. Results 1,463 patients were included, mean age (±SD): 56 (±13.5) years; mean disease duration (±SD): 14 (±8.5) years. Patients had a mean (±SD) of 4.2 (±1.2) visits and a mean (±SD) follow-up time of 3.6 (±1.4) years. Patients with at least 1 visit in MODAS or in SEDAS had significantly higher numbers of flares, worse HRQoL, more damage accrual and more hospital admissions. Both, damage accrual and hospital admissions were significantly higher in SEDAS than in MODAS (Table 1 and Table 2). When comparing MODAS and SEDAS vs low disease activity, worse were the outcomes in the moderate/severe activity states (Figure 1). Table 1. Outcomes, according to the number of visits in SEDAS. Table 2. Outcomes, according to the number of visits in MODAS. Figure 1. Comparison of risk of admissions, damage accrual, flares and quality of life between different states of activity with each other. Conclusions Patients who were in MODAS or SEDAS at least once had worse outcomes in terms of numbers of flares, HRQoL, damage accrual, and hospital admissions. Furthermore, the more time spent in these states entailed greater risks. These results emphasize the importance of an adequate stratification of disease activity in SLE patients.
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 | 0.061 | 0.048 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.007 |
| Bibliometrics | 0.012 | 0.009 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.005 | 0.004 |
| Research integrity | 0.002 | 0.005 |
| Insufficient payload (model declined to judge) | 0.004 | 0.002 |
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".